


There Were Days

by stillwaters01



Category: Star Trek: The Original Series
Genre: Character Study, Christine Chapel is an awesome nurse, Drama, Friendship, Gen, Hurt/Comfort, Life in sickbay, McCoy is an awesome doctor, Medical
Language: English
Status: Completed
Published: 2013-09-08
Updated: 2013-09-08
Packaged: 2017-12-26 01:25:23
Rating: Teen And Up Audiences
Warnings: No Archive Warnings Apply
Chapters: 16
Words: 86,042
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/959950
Author URL: https://archiveofourown.org/users/stillwaters01/pseuds/stillwaters01
Summary: <blockquote class="userstuff">
              <p>McCoy is critically injured and Christine Chapel does what she does best. A character study of Leonard McCoy and a look into the world of the Enterprise medical team.</p><p>(Originally written and posted on fanfiction.net 12/29/09 - 8/16/13)</p>
            </blockquote>





	1. Chapter 1

**Author's Note:**

> Disclaimer: Not mine. Just playing, with love and respect to those who brought these characters to life.
> 
> Written: 12/2009 – 6/2010. 6/14/13, 8/11/13 – 8/16/13.
> 
> Notes: This was the first Star Trek story I began writing and the first piece of work after a four year writing hiatus. Dr. McCoy has always been my favorite character and after a marathon of the new movie and the old series, I finally got something in my head that wouldn’t leave me alone.

 

 

 

There were days Christine Chapel loved being a nurse.

 

Crouching on the cold Engineering grating between Dr. McCoy and a nervous Ensign with a badly dislocated knee, listening to the familiar melody of McCoy’s gentle, diversionary teasing, Scotty’s staccato stops as he realized his worried pacing and abruptly stamped his feet in place, and the soft, supporting whir of the medical scanner, she couldn’t imagine being anywhere else.  She slipped effortlessly into the conversation, dancing the give and take of humor and sarcasm, keeping one eye on the scan results, monitoring the Ensign’s vital signs and running McCoy’s potential orders through her head in preparation for treatment. 

 

“I can’t believe I fell that hard.  It wasn’t even that much of a shake,” Ensign Tenzin berated himself, the nervous dart of his eyes between the swollen, displaced knee and the medical kit betraying his relatively even tone of voice.

 

Christine threw herself forward to brace the injured knee as the ship shuddered again.  When the deck leveled out again, she gently moved one hand to Tenzin’s radial pulse, while her eyes shifted to his chest and face.  He was tachycardic, tachypneic and as tense as a Vulcan confronted with emotional conversation. 

 

Keeping her fingertips lightly resting on Tenzin’s wrist, she met Dr. McCoy’s eyes and handed him the hypo of acetodone.  “15 milligrams of acetodone?” she both asked and confirmed.

 

McCoy nodded and grumbled, “Damn solar flares.  Why Spock insists on us flying through every one of the blasted things is beyond me.  What could possibly be different from the last three that threw us around?  If someone at Starfleet has nothing better to do than look at the same flare data over and over, I’d be happy to suggest a few things.”

 

Tenzin snorted back a laugh as Christine raised her eyebrows in a ‘please elaborate’ gesture and McCoy slid the hypo home.

 

“I take it you’ve developed a new filing system, Doctor?” Christine inquired innocently as she prepared the next round of medication while McCoy ran his hands over the knee, mapping out the anatomical landmarks.

 

Scotty began chuckling at the possibilities.  Tenzin, gaining courage from his commanding officer and relaxing as the pain medication took effect, piped up with mock-seriousness, “I believe telling Starfleet brass to file their data where the sun doesn’t shine is considered insubordination, Dr. McCoy,” he smiled.

 

“You’ve been spending too much time with Mr. Spock, son,” McCoy muttered.  Tossing aside that mental syntactical comparison, he met Tenzin’s eyes.  “How’s the pain now?”

 

“Better.  Just kind of in the background now,” Tenzin said, his gaze turned inward, mapping out the pain level as he spoke.

 

“Good.  Ready to get that knee back in place?”  McCoy asked.

 

Tenzin grimaced.  “This is still going to hurt, isn’t it?”

 

McCoy nodded sympathetically.  “What we just gave you will take the edge off, but you’ll still feel the knee moving back into place.”  Christine loved him for this.  She had worked with her share of physicians who downplayed the importance of being honest and informative.  McCoy could be surprisingly nursing oriented in his patient approach. 

 

Tenzin looked away, biting his lip and mentally preparing himself for the experience.

 

Scotty knelt next to the Ensign.  “It’ll be all right, lad,” he said gently.  “Nothing a bit o’ scotch and the good Doctor’s hypo cannae fix.”  He grimaced as both McCoy and Chapel shot him disapproving looks at the idea of scotch and pain medication.  Scotty cleared his throat.  “At least yours happened in the line o’ duty,” he changed tactics, glancing up at Christine and McCoy with a combination of apology and pleading. 

 

With Tenzin occupied with Scotty’s tale of dislocated shoulders and drunken brawls, Dr. McCoy and Nurse Chapel conferred over the medical kit.  “What are you thinking?”  Christine asked.

 

“Total nerve block might work,” McCoy thought out loud, “but he’ll still know what we’re doing and I think that’s what scares him the most.”

 

Christine nodded in agreement.  She rummaged through the sedatives and her eyes lit up.  “What about dimzolam?  I know he’s got a low dose narcotic on board, but we give him just enough to put him out, I’ll monitor his respiratory status and BP continuously and as soon as you’re done, we reverse him.  He’ll be out for the procedure and get the amnesiac effects as a bonus.”

 

McCoy thought it over.  “I usually don’t like to use it outside sickbay, but we’re close enough that I’m willing to give it a try.  I’d like to get that knee back in place sooner rather than later and I’d rather not move him until it’s done.  You have flumzil in there?” he nodded toward the kit.

 

Christine pulled the hypo out, double-checked the label and set the dosage.  “Ready.  We’ve also got laxnone in case you want to reverse the narcotic.”  She placed the hypo closer to her end of the kit, while setting the dosage for the dimzolam and handing that hypo to Dr. McCoy.

 

McCoy double-checked the hypo and nodded, while Christine began explaining the plan to Ensign Tenzin and Scotty. 

 

“So I’ll be out the whole time and when I wake up, I won’t remember any of it?” Tenzin asked incredulously.

 

“Most people are out completely,” Christine clarified. “Some people stay in a twilight state where they are semi-aware, but even those people don’t remember anything once they’re fully awake again.”

 

Tenzin nodded.  “Sounds good to me,” he consented.  Scotty met Christine’s eyes and nodded his thanks.

 

McCoy ran a baseline scan of the Ensign’s vitals and nodded, pleased with the results.  With the anxiety and pain addressed, everything was well within normal.  “What do you say, Sean?” McCoy smiled at Tenzin, “Ready to nap on duty?”

 

Tenzin grinned.  “You bet, Doc.”

 

Christine grabbed the scanner, noted the baseline readings, and set the machine for continuous scan as McCoy administered the hypo.  She looked up at Tenzin.  “You may feel a disconnected feeling, or like everything is going gray and sounds are fading,” she informed him.

 

“Oh yeah,” Tenzin breathed.  A moment later, he was out. 

 

“Nice call,” McCoy said, nodding toward the empty hypo.  Christine smiled as McCoy checked Tenzin’s level of sedation, asked for a reading, and moved his hands into place. 

 

The ship rolled left, hard.

 

Scotty, McCoy and Christine scrambled to keep the Ensign in place and prevent the medical kit from disappearing down the corridor.  McCoy met Christine’s eyes, looking for confirmation that Tenzin’s vitals were still strong and once she nodded her assent, he sprang to his feet with a growl and stalked over to the comm. 

 

“Bridge.  Kirk here,” came the reply.

 

“Would you leave that damned flare alone and stop dislodging crewmembers all over the ship?”  McCoy demanded, flicking his eyes back at Christine and Tenzin.

 

“I take it you’re in the middle of something?” Kirk replied dryly. 

 

“I’ve got a sedated patient in Engineering about to get his knee put back in place,” McCoy noted Kirk’s sympathetic groan, “and unless you stop throwing him and his medical officers around…..” McCoy grabbed at the wall as the ship lurched again.  Christine swore softly as the scanner dropped.  She laid a hand on Tenzin’s chest to monitor his respirations while Scotty retrieved the scanner and reset it for her.  “Dammit Jim, you want to come down here and do this procedure?” he shouted.

 

“Not particularly, Bones.  I’ll have Spock pause the readings and we’ll hold position until you’re done.”

 

The ship shuddered slightly as Sulu made the changes.  “Jim….” McCoy threatened.

 

“Noted, Bones,” Kirk said. “We’re not going anywhere.  Get back to your patient.”

 

McCoy grumbled his acknowledgment and jabbed the comm button.  He returned to Tenzin’s side and glanced at Christine for report. 

 

“Vitals steady,” she reported, “Heart rate 82, resps 12, deep, even and regular, BP 110/72, sedation still adequate.”

 

McCoy nodded, replaced his hands and swiftly manipulated the knee back into place.  Scotty winced as McCoy ran his hands over the joint, double-checking the placement.

 

“Vitals still holding nicely,” Christine reported.

 

“Good,” McCoy said.  “Now, see how easy that is when the damn ship stays still?” he grumbled as he dug through the kit for the cortisone and a longer-acting pain medication.  “Ready to reverse him?” he asked Christine.

 

She placed the scanner down for a moment and reached for the flumzil.  She resumed her readings as McCoy administered the anti-inflammatory and pain medications.  At his nod, she gave the reversal agent.  A few moments later, Tenzin’s eyes fluttered open.  He blinked a few times, managed to focus on Christine and realized, “it’s over already?”

 

Christine smiled.  “Yep.  Good stuff, isn’t it?”

 

Tenzin yawned.  “Oh yeah.”

 

McCoy grinned.  “We’ll go over your discharge instructions a little later Ensign,” he said. “Just relax for now and we’ll get you a stretcher to sickbay.”

 

“M’kay right here,” Tenzin mumbled sleepily.

 

McCoy chuckled.  “That you may be,” he acknowledged, “but as your doctor, I have to insist on rest in a proper bed.”

 

“Also, your back is not going to be happy with your lying on this floor once the drugs wear off,” Christine pointed out.

 

“That too,” McCoy laughed.

 

“Okay Doc,” Tenzin closed his eyes. 

 

“Nice work,” McCoy nodded to Christine as she separated the used hypos from the fresh ones in the kit while taking a few last readings. 

 

“Thanks.  You weren’t so bad yourself,” she grinned back.

 

“No respect,” McCoy grumbled good-naturedly.  He pulled himself to his feet with a groan, stretched out his back and took the proffered kit from Christine. 

 

Christine watched him walk over to the console, lay the kit down and grab the PADD to log the medications in the Ensign’s record.  Normally, she would do that when logging the vital signs, but one of the great things about Dr. McCoy was that he never separated work into “doctor” and “nurse.”  Everyone in sickbay knew not only their own duties, but those of the other medical staff they worked with.  Not only was it essential for delegation, but it also tended to keep the workload spread evenly among the staff, with everyone stepping in wherever they were needed.  While McCoy began charting, Christine called sickbay for a stretcher and continued monitoring their patient.  “Vitals all back to baseline,” she reported, tucking the fire blanket Scotty had brought from the Engineering kit around the sleeping form.

 

McCoy nodded and charted the information as Scotty thanked them both and moved to meet the orderly coming in with the stretcher.

 

Christine met McCoy’s eyes and they shared a soft smile.  This was what it was all about.  Christine loved working with a doctor just as committed as she was, if not more so, to providing excellent, individual patient care.  It wasn’t just about diagnosing problems and giving medications – it was treating the patient as a person, finding out what worked best for them and supporting and educating them through the process.  What could have been an anxiety-ridden dislocation repair became something completely different.  By recognizing and validating the Ensign’s anxiety, they were able to come up with an alternate treatment plan that was more acceptable to both the Ensign and his medical team.  Hell, they had even gotten the Ensign to share a sarcastic comment or two with his senior officers – a testament not only to adequate pain medication and a good bedside manner, but to the relationship the medical staff was allowed to have with the crew; the relationship Dr. McCoy encouraged. 

 

Christine Chapel smiled.  A good end to the shift.  Yes, some days, she really loved being a nurse.  She helped Scotty and the orderly, Mike, move Tenzin onto the stretcher.  As Scotty insisted on helping Mike move the Ensign back to sickbay, Christine took the opportunity to stretch out herself.  She turned to McCoy, who was packing up the kit.  “Do you want to log the vitals now, or back in sickbay?” she asked.

 

“Nah, you can do them in sickbay,” McCoy’s eyes twinkled. “I wouldn’t want to deprive you of the pleasure.”

 

Christine rolled her eyes.  “You want me to walk with them?”

 

“Sure.  I’ll be right behind you,” McCoy replied, heading for the comm.

 

“You going to apologize for threatening the Captain?” Christine teased.

 

McCoy raised his eyebrows in an ‘are you kidding me?’ gesture and snorted back a laugh.  He hit the comm button lightly.  “McCoy to Bridge.”

 

“Ah, Bones.  I take it I can have the ship again?” Kirk teased.

 

“As if I could ever take her away,” McCoy grumbled with a chuckle.  “We’re done down here, so if…..” he was cut off as the ship lurched to the right.

 

Scotty motioned to Mike to place the stretcher on the floor.  Christine took over stabilizing Tenzin on the deck as Scotty ran to the comm, panic flitting across his face.  “Captain, that felt like a hit,” he exclaimed.

 

“What the hell could have hit us here?” McCoy demanded, pulling himself off the floor.

 

“It appears the flare has moved to our current location,” Spock’s voice joined the conversation.

 

“They can do that?!” McCoy asked incredulously.

 

“Indeed, Doctor,” Spock explained patiently. “The very nature of the phenomena would suggest….”

 

“Dammit Spock, I’m a doctor, not an astrophysicist.  A simple ‘yes’ would do,” McCoy grouched. 

 

“Scotty, I may need some creative engineering,” Kirk’s voice returned over the comm.

 

“Aye, Captain,” Scotty acknowledged.  He looked over at McCoy.  “Will ye be all right getting the Ensign back?”

 

McCoy waved him to his station.  “He can sit tight for now.  I’ll get another orderly down here to give us a hand.  I’ll want a few more stabilizing hands anyway with all this rattling around.”

 

Scotty nodded hurriedly and rushed to his console.  McCoy called sickbay for another orderly, then checked in with the Bridge again.  “Jim, is everyone all right up there?” he asked.

 

“A few bruises, but nothing serious,” Kirk replied. “And before you comment on my medical judgment, I’ll be sure to send them to you later to be checked out.”

 

McCoy smiled ruefully.  “Acknowledged Captain,” he replied.  As he moved to end the communication, the ship groaned and violently pitched to the right.  McCoy slammed into the console, grabbing it for support.  Sparks flew around Scotty’s station down the corridor.  “Scotty, watch ou - ” his warning abruptly cut off as the console acting as his support exploded in a shower of sparks and wild, displaced energy.

 

“Doctor!” Christine shouted as he was thrown back from the console.  She grabbed the kit, double-checked Tenzin and told Mike to stay with the Ensign before bolting to her feet and running down the corridor.

 

“Doctor McCoy!” Scotty called out.  He waved away the sparks dancing around his head, grabbed the nearest fire extinguisher and rushed to the smoking console while shouting for one of his crew to take his station.

 

Christine dropped to her knees at McCoy’s side, touching the nonconductive material of the medical kit to his body to ensure she wouldn’t end up on the floor as well.  Satisfied it was safe, she shook him gently, calling his name.  No response.  Her stomach clenched.  A nurse’s intuition, her instructors had told her back in school: sometimes you’ll just know something’s wrong.  As she bent over McCoy’s face, tilting her head to look at his chest while listening and feeling for breath against her cheek, her intuition was screaming at her. 

 

Scotty ran over.  “Is he….?” His question was cut off by Kirk’s demand for warp.

 

Christine waved him off.  “Go!” she insisted.  She concentrated on her assessment.  Nothing.  Respiratory arrest.  She felt for his carotid, counting the seconds, ignoring the scanner nestled in the kit at her side.  Working for Dr. McCoy, you couldn’t help but learn to do some things the old-school way and to trust your own senses over the machines at times.  Ten seconds and no pulse.  Cardiac arrest.  Shit.

 

She didn’t even bother checking a rhythm.  She knew what it was going to be.  She began chest compressions, silently thanking Dr. McCoy again for teaching the staff and crew CPR.  “It may not be a cardio stimulator and fully stocked cardiac med kit,” he had said at the in-service, “but it gives the patient a chance when you’re on a primitive planet with no medical supplies and a halfway repaired transporter.  You won’t be as effective as the heart, but you can at least keep some oxygen circulating.” 

 

“Mike,” she shouted down to him.  “Stay with Tenzin, but as soon as your relief comes, I need you.”  She sucked in a breath and turned toward Scotty.  “Scotty, do you have a cardio stimulator down here?”

 

“Aye, Dr. McCoy had one stocked here last month,” Scotty responded, fingers still flying over the console as energy demands continued to pour in from the Bridge.  After one too many cardiac emergencies due to errant mechanical energy, McCoy had insisted on stocking certain areas of the Enterprise with cardiac kits and teaching the crew the basics of applying and setting the cardio stimulators.  “It’s too big a ship,” McCoy had pointed out to Kirk, “and the longer a crewmember is in cardiac arrest without a cardio stimulator, the less the chance they’re going to come out of it.  There’s no excuse for the number of cardiac fatalities on Federation starships, especially in Engineering, Jim.”

 

“Get anyone you don’t need working on the engines to bring it to me,” Christine shouted, trying to remember where she was in her cycle count.

 

Scotty’s eyes widened as he paged Ensign Settler to follow out the order.

 

Zandin Klebsl ran into Engineering.  Mike grabbed the orderly, filled him in and sprinted to McCoy’s other side.  He watched Chapel do a quick pulse check.  “Anything?” he asked breathlessly.  She shook her head and he picked up the compressions while she grabbed the scanner and checked the rhythm.  V-fib.  “Probably R on T,” she muttered to herself.  Her head snapped up as Ensign Settler skidded to a halt next to her with the cardio stimulator already out of the kit.  Mike briefly stopped compressions while Christine applied the device and applied the first setting, then resumed compressions while Christine administered a hypo of epinephrine and cordarone.

 

“Continue compressions for another two cycles,” Christine ordered Mike, “then we’ll do another pulse check.”  Mike nodded, breathing hard.

 

Christine forced herself to take a deep breath.  The event had been witnessed, compressions started quickly, and thanks to McCoy’s pilot program with the cardio stimulators, the device was placed and drugs delivered in a timely manner.  Did it give him a better chance?  Sure.  But it really didn’t mean much.  Even with immediate, proper treatment, lethal dysrhythmias were still very often lethal.  Christine looked up.  “Hold compressions,” she said.

 

The clock was ticking.  Time was muscle.  The ship bucked left, the warp engines screamed, the comms were thick with tension, Scotty was throwing out last-ditch escape efforts.

 

“Nurse Chapel, the Captain is calling for Dr. McCoy,” Ensign Settler relayed the comm message nervously.

 

Christine sighed. 

 

There were days she loved being a nurse.

 

She reached for McCoy’s carotid artery.

 

Suddenly, today wasn’t one of them.

**Notes for the Chapter:**

> Medical notes: 
> 
> Most of this is based off my own medical knowledge. Most of the drugs in this story are simply variations of the names of drugs used today. I took the liberty of having characters use hands-only CPR as the current research is pointing that way anyway and the discussion of cardio stimulators and cardiac drugs largely follows the Advanced Cardiac Life Support algorithms from the American Heart Association today. “R on T” phenomenon occurs when something, like an electrical stimulus, hits the heart during a certain part of the cardiac cycle (the “T” wave” on the EKG) where it is vulnerable to being taken over by that new stimulus. This tends to lead to lethal rhythms like v-tach (ventricular tachycardia) or v-fib (ventricular fibrillation). Most of the Engineering discussion about energy requirements and ship maneuvers through a solar flare are pretty sketchy – I’m a nurse, not an engineer :)


	2. Chapter 2

**Summary for the Chapter:**

> McCoy is critically injured and Christine Chapel does what she does best. A character study of Leonard McCoy and a look into the world of the Enterprise medical team.

 

 

 

“Nurse Chapel?” Ensign Settler’s voice quavered.

 

Christine held her free hand up, signaling the Ensign to wait. “8….9…..10……nothing.  Dammit!  Mike, count me off,” she pulled her hand from McCoy’s neck and took over compressions.  “Ensign, call the Bridge and find out what the Captain needs, then go help Zan move Tenzin over here.”

 

“Zan?” Settler repeated.

 

Christine cursed silently.  “The orderly down the corridor,” she clarified.  “Mike, where am I?” she asked.

 

“Starting the fifth cycle now,” Mike reported, tapping his hand lightly on the floor to keep the rhythm as he talked.

 

“Prep another round of epi and cordarone.  1 milligram and 150 milligrams,” Christine huffed as McCoy’s ribs yielded under her hands. 

 

“1 milligram epi, 150 milligrams cordarone,” Mike confirmed, grabbing the hypos.

 

“Nurse Chapel, Captain Kirk reports Lt. Uhura was cut by a broken panel.  It won’t stop bleeding,” Settler called out as the comm switched over to Scotty and Kirk finalizing a massive power push.  The Ensign rushed down the corridor to help Zan with Tenzin.

 

Christine stopped compressions at Mike’s signal and reached for a pulse check as the Enterprise shuddered and struggled to earn Mr. Scott’s, “that’s it lass, come on, just a wee bit more.”  She felt the ship surge with power, heard Scotty’s whoop of delight, and secretly pleaded with the massive vessel to share some of that incredible power with the man lying in front of her. 

 

“Well done, Scotty!” Kirk’s congratulations came over the comm.

 

The Enterprise glided through space, free of the flare.  Christine knew she should be glad for the renewed stability, but the sudden stillness only emphasized McCoy’s own unnatural stillness.  The ship thrummed with wild, relieved life.  Under her fingertips, McCoy’s carotid lay silent.

 

Zan skidded to her side.  Christine grabbed the hypos from Mike, administered the drugs and told Mike to resume compressions.  She glanced at the time.  “He’s been down almost four minutes,” she realized quietly.  Steeling herself, she looked at Zan.  “Call the Bridge and tell the Captain to get Uhura down to sickbay.  M’Benga can take care of the laceration.”  She turned back to the cardio stimulator.

 

“Dr. M’Benga’s in surgery,” Zan replied.

 

“What?!” Christine glared at him.  “He’s just coming on shift.  Why the hell is he in surgery?”

 

“Lt. Commander Kelly’s appendix,” Zan tried to keep his voice level as Christine kept one ear on his explanation and the rest of her attention on adjusting the cardio stimulator as Mike huffed through the compressions.  “Starfleet Medical pulled rank and changed the schedule last night, figuring a scientific survey would be quiet enough to schedule a routine procedure.”

 

“Bridge to McCoy,” the comm demanded.

 

“Goddammit!” Christine exploded, somehow managing to keep from screaming that out loud.  When it rained, it damn well poured.  She had an Ensign recovering from sedation with a freaked out Engineering crewmember monitoring him two feet away, a communications officer spurting blood, an angry Captain yelling for his CMO, God knows how many other injuries from the crew being thrown around the ship just waiting to be discovered, two orderlies demanding her attention for two different patients and the only doctor who currently had a beating heart was in the middle of a routine appendectomy because some assholes in Starfleet Medical realized the head of xenoneuropsychiatric research had never had his goddamned appendix out before being assigned to space and decided that nothing could possibly go wrong during a routine scientific survey.  How many times had she pulled double and triple shifts with the rest of the medical staff to treat a sickbay full of injured crewmembers after “just a routine mission?”  When would Starfleet realize that two doctors and a handful of nurses were not nearly enough to cover a few hundred starship crew?  One day she’d sit and figure out the ratio.  More importantly, why wouldn’t McCoy damn well BREATHE?

 

Christine forced herself to take a breath, choking back a sobbed laugh as she realized how much she sounded like McCoy right now.  She moved her hands from the cardio stimulator, double-checking the new setting.  “Zan, tell him to get Uhura to sickbay.  If Starfleet hasn’t changed any more of our schedule, Mara should be the nurse on duty.  She can take care of the laceration under M’Benga’s orders.  He can sign off on it later.”  She watched the orderly rush to the comm just as Kirk launched into another demand for a reason why his CMO wasn’t on the Bridge.

 

Christine bit her lip, keeping her angry retort to herself.  She looked up at Mike.  “Stop compressions,” she said, running the scanner over McCoy’s thorax.  Still v-fib.  Shit.  “Stand clear,” she said firmly, checking the wireless connection between the cardio stimulator and the medical scanner.

 

“You’re going to shock him?” Mike asked incredulously.  He could count on one hand the number of times he’d seen that done in his time with the Enterprise medical staff.  Normally, just setting the cardio stimulator to a regular sinus rhythm was enough to override the current dysrhythmia.  No one shocked anymore.

 

“He’s not responding to the RSR setting,” Christine pointed out. “This is his only chance.  We’re reaching five minutes, so shut up and stand clear!”

 

Mike sat back on his heels, eyes flicking to Zan, who was relaying Christine’s message to the Captain.  Kirk acknowledged that he would send Uhura down to sickbay, but couldn’t stop himself from exploding into the rant that Christine had managed to keep to herself.

 

Christine double-checked that no one was touching McCoy’s body.  “Charging now. Clear?” she demanded.

 

“Mike clear,” Mike replied.  He got up and checked Tenzin and Settler.  “Tenzin and Settler clear.”

 

“Chapel clear.  Delivering shock,” Christine pushed the scanner button and swallowed hard as McCoy’s body twitched.  “Resuming compressions,” she declared, starting the next round.

 

Zan was attempting to pacify the Captain, trying out some of the therapeutic communication techniques he had picked up from the nursing staff.  Validating James T. Kirk’s feelings only seemed to go so far with him though.

 

“Hold compressions,” Mike finished the count. 

 

Christine felt for his carotid.  “Come on…..” she whispered.  She grabbed the scanner to confirm.  No pulse.  V-fib.  “Dammit, Leonard!” she finally exploded.  “I am NOT telling the Captain that you’re dead.  That leaves one option.  I realize you may be angry with electricity right now, but you’d better damn well take this next burst.  If you were a patient of yours, you’d be shouting and bouncing all over the place.  ‘No’ is not an option.”  She increased the voltage.  “Just give me a perfusing rhythm, that’s all I’m asking,” she pleaded softly.  She was a nurse, she had lost patients to cardiac arrest before and she knew the likelihood of that happening now, but it sure didn’t make it any more acceptable to lose her CMO, her friend, someone she truly enjoyed working with and knowing.

 

“Charging now.  Clear?” she fell back on the cold comfort of protocol.

 

“Mike clear.”

 

“Tenzin and Settler clear,” she heard Settler’s soft voice waver.

 

The comm was silent.  Zan’s eyes were focused on her.

 

“Chapel clear.  Delivering shock.”  She pushed the button, then motioned Mike in to resume compressions.

 

“What’s going on?  Is Bones....?” Kirk demanded over the comm, his Captain’s authority wavering under the worry in his voice as he reached McCoy’s name. 

 

Christine cursed herself silently.  Kirk must have heard her diatribe.  “He’s down, Captain,” she reported firmly, her tone putting a halt to further questions.  She resumed the count, but stopped halfway through the next cycle as her gut suddenly kicked in with enough force to take her breath away.  She had seen dozens of patients hold onto life until loved ones allowed them to let go.  If they could reverse that, just maybe….. 

 

 “Zan, take over the count,” Christine ordered.  She raised her voice to reach the comm.  “I need you to yell at him,” she said to Kirk. 

 

“What?!” Kirk cried.

 

“Just follow me, Captain,” Christine ordered.  She looked down at McCoy, focusing her attention away from the rebounding sternum, to his face.  “Leonard McCoy, I may not be the shouter you are, but you’re damned well going to listen to me!  I have a patient here who insists on staying dead even though he’s been given every chance to live.  Now, I’ve picked up a lot from you, but you’re the only one I know who has ever shouted someone into a state of health so I need you to wake up!”  Before she realized what she was doing, she slapped him as hard as if she were waking Mr. Spock from a healing trance.  _“Oh God, I just hit a patient….and my boss!”_ she realized.  Her intuition pushed her forward – somehow, this was right.  _“Hell, he got a pregnant woman to cooperate with a good right cross,”_ she recalled. _“Might as well give it a shot.”_

 

Kirk had caught on.  “Dr. McCoy, this is unacceptable.  You can’t possibly hold life in such high regard if you refuse to come back to it!  I’m no doctor, but “first do no harm” seems pretty clear to me and your dying harms this entire ship.  Remember that disaster on Vega V?  My ears still ring from all the shouting you did, keeping my heart beating.  Revenge is a dish best served loud, Doctor.  WAKE UP!”

 

Christine smiled at the memory.  Zan was counting off the final ten compressions.

 

“Come on, Leonard!” Christine screamed, doing her best ‘I’m Leonard McCoy, CMO and I’m pissed as hell’ as the final compression was delivered and Mike sat back for the pulse check.

 

“Bones, I’d listen to her,” Kirk said seriously. “I wouldn’t mess with that voice.”

 

Christine pressed her fingers to the pulse point. 

 

“Please, Bones,” Kirk pleaded softly over the comm.  He cleared his throat.  “Please.”

 

“7…..8…..” Christine refused to believe it hadn’t worked.  It felt too _right_ not to have worked. 

 

“Chris?” 

 

She almost didn’t recognize Leonard’s nickname for her coming from Kirk’s lips.

 

This was his last chance.  Even with modern medicine, with cardiac tissue regenerators, antiarrhythmics, positive inotropes, cerebral reperfusion therapy, life support……he had been down too long and everyone knew that Leonard McCoy did not want to be kept alive by machines.  “Damned waste of technology,” he had muttered. “What’s left to keep alive?  Do an EEG – if there’s nothing there, pull everything and let them go in peace.”

 

Christine willed all of her attention to the delicate nerve endings at her fingertips, waiting for….. “There!” she cried out. 

 

The room around her remembered how to breathe.  “Bones?” Kirk called softly over the comm.

 

Christine frowned.  “Come on, give me another beat,” she whispered.  “There,” she said again.  “Mike, hand me that scanner.  Keep your hand here for a second.”  She did a rhythm check and compared it to her own count.  “Dammit, Len,” she muttered, reaching for the medical kit.  “Mike, resume compressions.”

 

“What’s wrong?” Kirk couldn’t understand.  “You just said he had a pulse.”

 

“He does, Captain, but he’s in an idioventricular rhythm.  Only the bottom chambers of his heart are pumping, so he’s not getting any blood from the top chambers, which supply fresh blood from the lungs, and the rate is too slow to take care of his body’s needs.  The compressions are to help keep blood moving.  On top of that, he’s still not breath …..” she was cut off by the sound of a strangled inhalation.

 

Zan darted over to the cardiac kit and grabbed an oxygen unit, handing it to Christine.  She adjusted the mask and set the unit to supplement McCoy’s agonal breaths.  “It’s about time you started breathing again,” she couldn’t help but smile, “but that agonal crap’s not going to cut it.”  The portable unit was no ventilator, but it could give a short burst of AC.  She set it for AC 12 and upped the oxygen to 100%.  They could worry about oxygen toxicity later.  Right now, the man needed to make up for six minutes of nothing.

 

“Zan, call sickbay and get anyone not busy with casualties down here with a stretcher and full emergency kit, including a mini-vent,” Christine ordered.  She turned to Mike and handed him the scanner.  “Keep one hand on his pulse and watch that rhythm.  Tell me if ANYTHING changes, got it?”

 

“Yes ma’am,” Mike affirmed, immediately focusing on the task.

 

Christine began preparing atropine to try and bring the heart rate up, while debating whether to attempt pacing or not.

 

“Heart rate’s increased from 30 to 40,” Mike reported.

 

Christine laughed.  “All right Len,” she put a hand on his shoulder. “We’ll lay off the electricity for now and try the drugs.”  She administered half a milligram of atropine as a shadow fell over her left shoulder.  She looked up, ready to issue orders to the sickbay staff and saw Jim Kirk wavering between kneeling down to touch his friend and fearing to move forward.

 

“Captain!” she exclaimed.  “I didn’t hear you come in,” she apologized, drawing in a breath to give him report.

 

“You’ve been busy,” he assured her, holding up a hand.  “Fill me in later.  Just take care of him.” He moved quietly to McCoy’s other side, kneeling on his right and keeping one knee lightly in contact with the doctor’s shoulder.

 

“Rhythm’s changed,” Mike reported.  “The scanner is just reporting bradycardia now.”

 

Christine frowned.  “Give me that,” she held out her hand for the scanner.  She looked at the display and called up a rhythm strip.  “Dammit,” she breathed. “Bradycardic a-fib,” she clarified.  “Mike, get me 1,000 units of rinhepin and 30 milligrams of demcorzen now and prep another dose of atropine, he’s back down to 30.”

 

As she administered the medications, Christine could see Kirk struggling not to ask what was going on.  “The top chambers of his heart are working now, but they’re quivering instead of pumping, so he’s still not getting as much blood to the bottom chambers as he should.  His heart rate’s still too slow to take care of everything and with the atria quivering like that, he’s at high risk of throwing a clot,” she explained.  “I’m giving him medications to increase his heart rate and to try and prevent clots and get his heart to break this rhythm.”

 

Kirk nodded, keeping his eyes on McCoy’s face.

 

“This often happens after resuscitation, Captain,” she said softly.

 

“Doesn’t make it any better,” Kirk muttered.

 

“No it doesn’t,” Christine agreed.

 

Kirk suddenly looked up.  “Is this a perfusing rhythm?” he asked.

 

Christine glanced up from the scanner.  “What?  Umm, yes, it is.  Not a great one, but it’s better than nothing.”  She met Kirk’s eyes with a question.

 

Kirk chuckled.  “Well, you did just ask for a perfusing rhythm,” he reminded her, a trace of the old mischievous cadet in his eyes.

 

Christine had to remind herself of her own oath.  Damn smartass starship Captains.  “Leonard, I swear, if you stroke out and leave me with him….” she muttered, adjusting the scanner to display a full perfusion scan alongside the EKG analysis. 

 

“It’s true what they say about people working together,” Kirk piped up again.  If he didn’t distract himself from how bad this really was, he was going to lose it.  Or start pacing, and pacing meant leaving Bones’ side, so it really wasn’t an option.  “You’re really starting to sound just like him.”

 

Christine glared at him as the sounds of rattling medical equipment and hurried footsteps reached her ears.  Thank the Lord for reinforcements.  She pointed a finger at McCoy.  “Just keep that heart beating, Leonard,” she ordered. “No more changes until we reach sickbay and I can stop doing both our jobs, deal?”

 

Technically, McCoy kept his end of the deal.  Nothing changed as they rushed up to sickbay.  His heart was still beating, albeit still inefficiently, when they got him on the biobed monitors.  He even waited until M’Benga poked his head out of surgery to start getting report while the tissue regenerator went through its final scan of the incision line.  It wasn’t until Christine breathed out a sigh of relief at having gotten McCoy back to sickbay and further treatment that the oxygen alarm began screaming.  McCoy had breathed out too, and dropped his oxygen saturation by almost half.

 

“What’ve you got Chris?” M’Benga called from surgery.

 

Christine ran forward with the scanner.  McCoy was on the mini-vent with settings that didn’t require his lungs to do any work of their own.  He was still on 100% oxygen, so it wasn’t lack of supply from their end.  Christine cursed as the scanner confirmed the most likely culprit.  “PE,” she reported, scrambling for the anticoagulant kit while passing the scanner to Mara to pinpoint the exact location in case plan ‘A’ didn’t work. 

 

Kirk moved out of the way, looking lost.  “Pulmonary embolism,” Christine explained as she drew up several medications and lined them up, understanding how difficult it was for Kirk to not feel in control of a situation.  “The a-fib led to a clot blocking off blood flow in his lungs.”

 

Christine glanced up at the time, noting the start time for the first dose.

 

Her shift had ended two hours ago.

 

She sighed heavily and called to M’Benga for the first order as McCoy’s face began attempting to match his science blues.

 

 There were days…..

**Notes for the Chapter:**

> Medical notes: 
> 
> \- “One day she’d sit and figure out the ratio” refers to nurse to patient ratios. Ask any nurse about this issue and you’ll hear plenty about how nurses are spread too thin, with too many patients, too many added responsibilities and paperwork and not enough time to care for the increasingly complex medical situations in hospitalized patients today. I figured that’s something that still wouldn’t have changed in the Enterprise’s time (*grin*)
> 
> \- RSR stands for “regular sinus rhythm” also known as “normal sinus rhythm.” This is the textbook normal heart rhythm, with a heart rate between 60-100 beats per minute. Tachycardia is anything over 100 beats per minute and bradycardia is anything under 60 beats per minute (or 50 beats per minute, depending on who you ask now).
> 
> \- “Hell, he got a pregnant woman to cooperate with a good right cross,” she recalled, “might as well give it a shot.” This is in reference to the TOS episode, “Friday’s Child” – oh, McCoy, how I love your brand of medicine.
> 
> \- AC stands for “assist control” and is a setting on mechanical ventilators used in hospitals today. AC 12 means that the machine is set to deliver 12 breaths per minute to the patient. This setting delivers exactly what is programmed into the machine (breaths per minute, oxygen percentage, volume of air) to the patient without them having to be able to do any of that on their own.
> 
> \- “Her shift had ended two hours ago” – again, ask any nurse and they’ll tell you that if something is going to go wrong, it’ll be at shift change. Murphy’s Law of nursing.


	3. Chapter 3

**Summary for the Chapter:**

> McCoy is critically injured and Christine Chapel does what she does best. A character study of Leonard McCoy and a look into the world of the Enterprise medical team.

 

 

“He’s got 1,000 units rinhepin on board for the a-fib,” Christine yelled over the screaming alarms as M’Benga desperately tried to divide his attention between the operating table and his crashing colleague.  “What do you want?”

 

“O2 sat’s 70s and dropping,” Mara shouted, reaching up to silence the shrieking oxygen alarm.  The flashing red of a critical reading and the cyanotic tinge to McCoy’s face were enough.  Christine quickly nodded her thanks.

 

“Push another 2,000 now and start a drip at 1,000 an hour,” M’Benga ordered, “and get OR 2 prepped now.”  He strode back to Lt. Commander Kelly. 

 

Christine grabbed the hypo and administered the rinhepin.  “2,000 units rinhepin in,” she confirmed.  She looked up, searching for more staff.  “Mike,” she shouted over the still-screaming mini-vent alarm. “Get OR 2 prepped.  Zan, stay with Tenzin.”

 

Mara slammed the ‘alarm silence’ button on the mini-vent, disconnected the mask tubing, attached an ambu-bag and began manually pumping air into McCoy’s lungs.  “I’ve got him,” Mara said. “Go get the drip.”

 

Christine spun, sprinting for the intravenous cabinet.  Shaking her head to clear the last of the echoing alarms, she grabbed a bag of rinhepin and IV supplies and sprinted back to McCoy’s side and a new cacophony of voices.

 

“I’m all right,” she heard Tenzin insisting, pulling himself further up in bed.  “Go help the nurses,” he pleaded with Zan, who, bless him, stubbornly refused to leave the man’s side.

 

“You may not be as sick as Dr. McCoy, but Nurse Chapel still wants you monitored,” Zan repeated firmly.

 

“Nurse Chapel!” Tenzin shouted across the empty beds.  The blond head bobbed up briefly from securing the IV catheter.  “I’m fine.  Please tell Zan to help you guys,” he pleaded, wide eyes on the doctor’s still form.

 

Christine whipped around from priming the tubing at the sound of her name being called again.  Elise, the OR nurse assisting M’Benga, poked her head out of surgery.  “Give him to me, Chris,” she nodded at Zan. “I’m having M’Benga wake Kelly up now.  I can finish recovery with another set of hands and M’Benga can scrub again.”

 

Christine nodded.  “Zan, go help Elise in OR 1,” she ordered, hooking up the tubing and setting the pump for the prescribed dose and rate.  “But,” she stopped him mid-sprint, “I want you to hook Tenzin’s monitor readings into the second screen in OR 2,” she added.  She fixed Tenzin with a firm look.  “I know you feel fine and you probably are,” she said, “but if ANYTHING feels weird, you call us.”

 

“Yes ma’am!” Tenzin nearly saluted.

 

“Okay,” Christine agreed.  “Zan, go.  Elise, he’s all yours.”

 

“Sat’s still in the 70s,” Mara reported, double-checking that the oxygen was as high as it would go.

 

“No response to the extra 2,000,” Christine shouted to M’Benga as he rushed to discard his surgical scrubs and wash his hands.  “Drip’s started at 1,000 an hour,” she reported.  “What next?”

 

“You have the location scan?” M’Benga asked, scrubbing his hands furiously.

 

Mara nodded, changing her hands on the ambu-bag while waving away Christine’s silent offer to switch positions.  “On the scanner next to the anticoag kit,” she confirmed.

 

“Prep another 2,000 units for direct delivery and hook in the anatomical relay,” M’Benga ordered.

 

Christine put the hypo within easy reach of her right hand while setting the medical scanner to overlay McCoy’s anatomy with the previous two-dimensional scan result.  “You want a pre-op coag profile?” she offered.

 

M’Benga strode to Christine’s side and grabbed the proffered scanner, adjusting the display until he was sure of the clot location and local landmarks.  At his nod, Christine passed the hypo across her body, her eyes never leaving the monitors.  “2,000 units rinhepin,” she stated.

 

M’Benga gave the scanner one last check before plunging the hypo directly into the clot’s location.  “2,000 units rinhepin in,” he confirmed, switching to a localized perfusion scan.  “Maintain the drip and get me that coag profile now, please.”

 

“You okay, Mara?” Christine asked the other nurse.  They didn’t bag patients very often anymore and even with frequent practice, hand cramps were quick to develop. 

 

“Fine,” Mara acknowledged, switching the bag from her hands to under her arm.  “I’d be better if he’d do this himself though.”

 

Christine welcomed the quick laugh.  “Yeah,” she said softly as she began drawing blood.

 

“I’d be happy with a sat over 80,” M’Benga mumbled quietly, glaring at the scanner as if he could will the procedure to work.

 

“You want a VBG too?” Christine asked, looking nervously at the monitor.

 

“Might as well……” M’Benga trailed off, squinting hard at the scanner.  “There!  It’s dissolving!  Mara, keep getting that oxygen into him.  Christine, run the VBG, but set me up for an ABG as well, please.”

 

Mara pumped the ambu-bag with renewed vigor.  “That’s it Dr. McCoy,” she encouraged, “take it in.  Now, bring that sat up.”

 

Christine blew out a breath and turned to an unusually subdued James Kirk, who had taken up residence in a corner far enough out of the way, but close enough to see and hear everything going on.  “The clot is breaking up.  His oxygen level should improve soon,” she explained as she carried the blood tubes over to the analyzer, set the machine and returned to M’Benga’s side with the ABG kit.

 

“Sat’s 83% and rising,” Mara smiled.  “It’s about time,” she chided McCoy.

 

M’Benga nodded.  “Keep bagging him until he’s over 90% again, then put him back on the previous vent settings.”  He turned to Christine.  “We’ll draw the ABG once he reaches that point.”  He glanced at the monitor, then back to Christine.  “You said he was bradycardic a-fib in Engineering?  How low again?”

 

“Started in the 30s, came up to 40s briefly, then went back to 30s despite half a milligram of atropine.”  She followed his eyes to the monitor.  “And of course now he’s tachy from the stress of the PE,” she sighed heavily.  “Just what a damaged heart needs,” she grumbled.  “Dammit Leonard, why do you have to act like such a critical patient?!”

 

M’Benga took the outburst in stride.  While his own medical approach tended to be much calmer and often more polite than McCoy’s, he found he drew a certain amount of strength from the other doctor’s shouting, bouncing, and general passion in his pursuit of his craft.  McCoy’s sheer energy inspired him to step outside his comfort zone and, he had to admit, he missed that presence.  He very much appreciated Christine stepping into that role right now.  M’Benga brought his attention back to the monitor.  “You gave cordarone during the resuscitation?” he asked.

 

Christine nodded.  “150 of cordarone during the RSR setting, then 30 milligrams of demcorzen after the second shock, once the a-fib presented,” she confirmed.

 

“We’ll try the demcorzen again,” M’Benga decided.  “It may control the rate if nothing else and I need that heart rate down.  If the rhythm doesn’t break, we can cardiovert down the road…..” he trailed off as two sets of eyes looked up, mirroring his own concern.  He cleared his throat.  “But for now, start a demcorzen drip.  Bolus 100 milligrams, then continue at 60 milligrams an hour.  Once we get a sense of the damage and get in there with the cardiac tissue regenerator, that alone may give his heart the strength to break the rhythm.”

 

“Sat’s up to 95%,” Mara took the opportunity to interject.  “Switching back to previous vent settings now.”  She unhooked the ambu-bag, reattached the ventilator tubing and reset the machine.  “You got the monitors Chris?  I’ll grab the drip,” she nodded toward the intravenous cabinet.

 

“Got them,” Christine waved her on.

 

M’Benga verified that the clot had indeed dissolved and that the pulmonary vessels were clear.  He handed the scanner to Christine, who checked that the radial and ulnar arteries were both perfusing adequately before disinfecting both sites on McCoy’s wrist.  M’Benga pulled on sterile gloves, palpated the radial artery and made the stick.  While Christine held pressure on the puncture site, Mara returned with the demcorzen drip and began piggybacking it into the rinhepin line.  She set the bolus rate, took the new blood tube from M’Benga and moved to the lab.

 

“What now?” Kirk asked quietly from the corner as sickbay began to quiet down.

 

“Now we finally get a look at what’s going on,” M’Benga stated, taking up the scanner again and beginning his assessment.

 

Christine pulled the gauze from McCoy’s wrist to check the site.  “Shit!” she hissed, slapping the gauze back down and glaring at McCoy.  “You just had to make us do an arterial stick on your rinhepinized ass, didn’t you?” she muttered.

 

“I take it Dr. McCoy is somewhat anticoagulated?” M’Benga allowed himself a chuckle.

 

“Not ridiculously,” Christine said, “but enough that I could use a pressure bag,” she directed back toward Mara.

 

Mara closed the analyzer lid and grabbed the previous VBG and coag profile results.  “I got it,” she assured Christine, heading for the supply cabinet.  She returned to Christine’s side, lightly taped the dressing in place, and set the pressure bag over the site before turning to the IV pump and switching over the demcorzen rate.  “100 milligram bolus demcorzen in,” Mara stated, “setting hourly rate of 60 milligrams now.” 

 

Hands finally free, Christine motioned at the lab results.  “How bad?” she asked.

 

“Crappy,” Mara shrugged, “but better than you’d expect for a man who was dead for six minutes and just spent the last few satting in the 70s.”  She handed the PADD over as M’Benga blew out a breath.  Three sets of eyes whirled on him.

 

“How bad?” Christine repeated, this time directing her attention to M’Benga while waving Kirk over for the discussion.

 

M’Benga closed his eyes and handed her the scanner as he began rattling off the details.  “Second degree burns to both hands, rapid atrial fibrillation, generalized ileus…..and massive cardiac and cerebral cell death with several completely infarcted areas,” he practically whispered the final words.

 

Mara gasped.  Christine clenched the PADD hard.  It was Kirk who finally spoke.  “Heart and brain damage?” he choked.  He moved to McCoy’s face and rested a hand against the pale man’s cheek.  “Oh, Bones,” he whispered.  He looked back at M’Benga.  “What do we do?” he asked.

 

“There isn’t much we _can_ do Captain,” M’Benga said softly.  “The damage is extensive, even to modern medicine.”

 

Christine felt something stir deep in her gut.  She desperately tried to push back the threatening tears, but let go and let them fall as she realized they weren’t tears of despair.  They were tears of rage and that rage was fueling her inner Leonard McCoy.  “No,” she demanded, bolting up from her chair.

 

M’Benga looked up at her pityingly.  “Christine…” he began.

 

“No!” Christine shouted, stamping her foot.  “I know what his wishes are, but we have to try first.”  She looked at McCoy, a fond smile playing across her tear-streaked face.  “You didn’t see him with that tribble, Geoff,” she said softly. “Hell, he turned PTSD treatment on its head….. on a whim.  Who else would have thought a tribble could ground someone in the midst of a flashback?”  She turned back to M’Benga.  “He wouldn’t give up on us until his gut and his brain were completely exhausted.  Then he’d go raid someone else’s.  He deserves nothing less.”

 

Kirk’s eyes flashed his support, all traces of previous grief melting away.  The natural refusal to back down that made him Captain of the finest ship in the fleet took over.

 

“And if our guts and our brains aren’t enough?” M’Benga asked quietly.

 

“Then we do the EEG and if it says to let him go, we let him go,” Christine said simply. 

 

“Time to get to work, Doctor,” Captain Kirk said to his current CMO.

 

M’Benga sighed.  “All right, give me that PADD and start talking.  Let’s start with what we can fix most easily.”

 

“About damn time,” Christine grinned, bouncing on her toes as she reviewed the scan. 

 

Kirk tried not to stare.  She was practically _channeling_ Bones right now and he couldn’t help but grin himself.  This was going to work.  It had to.  “Burns,” he offered the group.

 

Mara stepped up.  “Easy – a round or two with the dermal regenerator and plenty of ROM while he’s out.  His hands will be good as new by the time he wakes up.  A-fib,” she threw out the next task.

 

“He’s got the demcorzen drip for rate control and possible chemical conversion,” Christine reiterated, “and rinhepin on board for anticoagulation so hopefully we won’t have a repeat of the clot incident.  Where do you want his coags?” she directed the conversation to M’Benga.

 

“His HSNR is 1.5 as of these labs,” M’Benga nodded at the PADD in his lap.  “Normally I’d want it over 2 for a-fib, especially since he’s already thrown a clot, but I also don’t want him bleeding out during surgery.  We’ll keep the rinhepin as it is and maintain continuous perfusion scans.  Make sure surgery is stocked with torpramine in case we have a hemorrhage issue.”

 

“What about sending him into surgery with the dysrhythmia?” Mara asked.

 

“I wouldn’t if I had a choice, but I’ve done it before,” M’Benga said, “and we really don’t have the time to wait.  His heart is so damaged that it probably won’t even think of converting until it’s stronger, so we continue what we’ve been doing and take care of the root issue.”

 

“The ileus will resolve once his body gets used to actually perfusing again,” Christine decided, “and we’re just going to have to deal with it again after surgery as a normal post-op issue anyway, so let’s move on.  Cardiac,” she stated, moving into the real challenges.

 

“There’s no way we can correct that kind of damage transcutaneously,” Mara shook her head.  “We need to get in there.”

 

“Direct regeneration?” Christine asked.  “We haven’t done that in awhile,” she turned to M’Benga.

 

He blew out a breath in agreement.  “True, but I think we have a chance.  Direct regeneration will allow us to both re-perfuse salvageable areas as well as stimulate new cell growth at the same time.  I don’t like the idea of opening him up in this weak of a state and with the rinhepin infusion, but we’ll just have to manage. ”

 

“Okay, so how do we fix his brain?” Kirk jumped in, encouraged by the plan so far.

 

Mara sighed.  “When I was stationed on Omega II, the native people brought us two of their miners, who had been trapped in a cave-in.  The men suffered severe head injuries, but the chief physician, Dr. Leurer, had worked with Dr. Kerebus from Starfleet Neurology.  Dr. Kerebus was launching his study on direct cerebral regeneration at that time, and as a last-ditch effort, Dr. Leurer contacted him and tried the procedure on the miners.  It worked well for brainstem injury, but was completely ineffective anywhere else.  The natives didn’t believe what the EEG showed them and thought that since the men were breathing on their own, they were fine.  They took them home where they eventually died from complications due to prolonged immobility.  They never woke up.”

 

Kirk shuddered. 

 

“Dr. Kerebus,” M’Benga thought out loud.  “I remember reading the subsequent reviews of that study.  He felt that they were so close, that it should work.”

 

“Wasn’t it something about the oxygenation?” Mara’s forehead creased with concentration.

 

Christine bolted from her seat.  “Tri-ox!” she shouted.  “I can’t believe I didn’t think of it earlier,” she chastised herself out loud.  “Kerebus and a student of his published an article last month in _Annals of Neurological Research_.  Kerebus was sure that the original study failed due to insufficient oxygenation during the process.  His student suggested using tri-ox to supplement direct regeneration.  It was only a case study, but the results were incredible – 94% improvement.  Leonard and I were discussing how that last 6% could be made up!”

 

Even M’Benga sat upright.  “Of course!” he recalled the article.  “They used a tri-ox mist over the regeneration sites.  The conclusions were the longer the tri-ox supplementation, the better, but the surgeon was limited in how long he could keep the brain exposed.”

 

“That’s where Leonard insisted there should be a way to prolong that time,” Christine said excitedly.  “He suggested a shunt placement, to allow continuation of tri-ox therapy once the skull was closed and the patient in recovery.”

 

“Placing a shunt in the brain?” M’Benga’s eyes widened.  “The last time I saw that done was in the history books.”

 

“Which means it just might work,” Christine insisted.  “We contact Dr. Kerebus, get his ideas and go from there.”

 

M’Benga opened his mouth, but closed it abruptly.  He wasn’t a neurosurgeon.  Hell, his specialty was Vulcans, but as there was only one Vulcan on this particular ship, he had to keep his general human surgical experience sharp.  _General_ , being the key word.  He was worried enough about attempting direct cerebral regeneration, but to perform a variation of a procedure that probably hadn’t been done in two hundred years……to insert a device that would give outside access to McCoy’s brain to try and improve a process only done once so far…..

 

M’Benga wanted to say “no.”  Direct regeneration was a leap enough.  He lifted his head, getting ready to speak again and was met with three sets of expectant eyes: Mara, all sweet hope that those two men didn’t die in vain; Kirk, wild excitement at the possibility of getting his friend back mixed with a hint of curiosity as to whether he could actually _order_ the current CMO to perform the procedure; and Christine…..radiating rage, brilliance and readiness and the start of a wild smile…….and suddenly McCoy was there, in Christine’s face and in M’Benga’s head.  _“Come on son,”_ the Southern drawl deepened with his passion, _“what’s the point of all this fancy equipment if we don’t use our God-given brains?  Just because something’s in the past doesn’t mean it’s meant to stay there you know.  Not every step we’ve taken has been an improvement.”_   M’Benga remembered sitting with McCoy, listening to those words after the CMO’s in-service on CPR and cardio stimulators to the crew.  Two days later, Montgomery Scott was walking out of sickbay with a clean bill of health, not three hours after an Engineering crewman, armed with McCoy’s CPR demonstration and a well-placed cardio stimulator, pulled him from cardiac arrest.

 

M’Benga sighed.  “All right,” he acquiesced.  “Get Dr. Kerebus on the line – I need to ‘raid his brain’ as you put it Christine,” he smiled softly.  “We’re going to need to make sure OR 2 is supplied for all this.  You should set up for a central line too – if we’re going to start pulling things from the history books, we might as well go big, as Leonard would say.  He’s going to need a lot of intravenous support once we’re through with him.” 

 

Christine grinned and rushed to the comm, asking Lt. Roberts in Bridge Communications to contact Dr. Kerebus and connect the call to M’Benga’s office.  “Oh my God!” she exclaimed as she ended the transmission.  “Mara, where’s Uhura?  Is she okay?”  She had completely forgotten about the injured communications officer.  The call about her bleeding laceration seemed like another lifetime ago. 

 

Mara laughed.  “She’s fine, Chris,” she assured her. “The laceration responded right away to a dose of coagulant, sealed beautifully and we sent her on her way with a dose of pain meds and antibiotic right before you guys got up here from Engineering.”

 

“Good,” Christine sighed, putting a hand out to steady herself on the desk.  “Now, you want OR prep or monitoring duty?”

 

“What I want is for you to get some sleep,” Mara said.

 

“What?” Christine countered.

 

“Chris, your shift has been over for how long now?” Mara asked, staring pointedly at the time.  “You’re due back in a few hours as it is for your next one.  Go sleep.  We can handle things from here.”

 

“But the OR….” Christine began.

 

“Mike’s already done the basics.  I’m already updating the equipment list,” she waved the PADD in her hand, “and he _can_ read.  I’ll double check the med stock once Zan gets back out here.”

 

“Elise….”

 

“….is fine!” Elise called from recovery. “And so is the Lt. Commander.  Zan’s all yours again.”

 

“Tenzin…..”

 

Mara turned around.  “Hey Ensign!” she shouted. 

 

Tenzin looked up and waved.

 

“You still alive?” Mara teased.

 

“Feels like it,” Tenzin smiled.

 

“Any pain, difficulty breathing or other concerns?” Mara threw back.

 

“Not a thing, Nurse,” he laughed.

 

“See?” Mara said.  “He’s fine.”

 

“What about other casualties from the solar flare?” Christine demanded.

 

“Tom’s on call,” Mara reminded her, “I called him in ten minutes ago to triage and treat what are very minor injuries.”

 

“And surgery….?”

 

“God, you’re dull,” Mara laughed sympathetically.  “I’m still on shift.  I’ll assist M’Benga in surgery.  Chris, if you stay here, you’ll either fall flat on your face or you’ll make a stupid mistake.  You know the rules – leave it here.  Go grab a few hours.  I’ll wake you if anything happens.”

 

Christine sighed.  She knew Mara was right.  “You’ll call me if ANYTHING happens?” she clarified.  “If he crashes, I want to know.”

 

“I’ll call you myself,” Mara promised.

 

Christine walked over the McCoy’s bedside.  “Be good for Mara,” she warned him.  She bent down and gently kissed his forehead.  She turned to Mara.  “Wake me once he’s in recovery,” she said.  She looked down at McCoy one more time.  “Even if it’s before my shift starts.  I want to be there,” her voice softened.

 

“You got it,” Mara said gently.  “Now get out of here.”

 

Christine smiled and strode out of sickbay.  Maybe she’d try some of the meditation Mr. Spock had been trying to teach her.  Leonard would love that. 

 

**Notes for the Chapter:**

> Medical Notes:
> 
> I had a great time working with McCoy’s voice in my head as to how to create future technology that would be on the Enterprise while melding it with current knowledge and practice. I tried to be as realistic as possible.
> 
> \- “O2 sats”, “sats” and “satting” all refer to oxygen saturation, which measures the amount of hemoglobin in the red blood cells that is saturated with oxygen molecules. Generally, a healthy person’s O2 sat should be ninety-five to one hundred percent.  
> \- “Priming the tubing” refers to setting up an IV drip. After attaching the tubing to the bag, you open the clamp all the way and let the fluid flow through to get rid of any air bubbles before hooking it up to the patient.  
> \- A “coag” profile is a set of blood values used to determine how fast someone is clotting. When a patient is on an anticoagulant (also known as a ‘blood thinner’), these levels are monitored frequently to determine whether the level is too high or too low and the medication is adjusted from that point. One value today is the INR (international normalized ratio). My made-up HSNR stands for “homo sapiens normalized ratio” since the Enterprise med staff would be working with several species.  
> \- A VBG is a “venous blood gas.” An ABG is an “arterial blood gas.” Both measure certain characteristics in the blood that are particularly important to monitor in a patient on a ventilator, such as the pH of the blood, levels of carbon dioxide and oxygen and bicarbonate. An ABG is more accurate in this sense and it requires sticking a needle way down into an artery to get the blood sample.  
> \- “Tachy” is an abbreviation of “tachycardia” (heart rate over 100 beats per minute).  
> \- In the a-fib discussion, “demcorzen” (which is a turned around spelling of Cardizem, a real cardiac drug used today) is used to try to bring down the heart rate when it is too high as well as to try and get the heart to break out of the a-fib and go back to a normal rhythm. Sometimes it works, sometimes it doesn’t. I gave the Enterprise crew a break and made the future version free of blood pressure issues. The real Cardizem tends to lower blood pressure, especially when given as a continuous IV drip. “Cardioverting” is using an electric shock to interrupt the heart and get it to reset to a normal rhythm. This is another way of stopping a-fib, but it is only done very early on after the rhythm is discovered as there is a risk for the patient throwing a clot if the rhythm has gone on too long.  
> \- “Christine pulled the gauze from McCoy’s wrist to check the site. “Shit!” she hissed, slapping the gauze back down and glaring at McCoy. “You just had to make us do an arterial stick on your rinhepinized ass, didn’t you?” she muttered.” McCoy is on an anticoagulant so he doesn’t clot as well in order to prevent clots from the a-fib. M’Benga just stuck a big needle all the way down into an artery in his wrist. Arteries are high pressure systems. You normally have to hold pressure on an ABG site for five minutes – Chapel is not happy about the implications.  
> \- “Ileus” is a term that generally refers to when the gastrointestinal tract stops moving. This can happen after a long period without blood flow and oxygen and it also tends to be a side effect of general anesthesia. The gut needs to wake up again.  
> \- ““You didn’t see him with that tribble, Geoff,” she said softly, “hell, he turned PTSD treatment on its head….. on a whim. Who else would have thought a tribble could ground someone in the midst of a flashback?”” The tribble and PTSD incident refers to my story Soul on Fire. McCoy insisted on telling me that story. I have no idea what M’Benga’s first name is, but according to Memory Alpha (http://memory-alpha.org/en/wiki/M%27Benga), his name is Geoffrey in two of the novels, so I went with that.  
> \- ROM stands for “range of motion.”  
> \- “You know the rules – leave it here.” This refers to one of the first things you learn as a nurse (or any medical professional) – leave work at work.


	4. Chapter 4

**Summary for the Chapter:**

> McCoy is critically injured and Christine Chapel does what she does best. A character study of Leonard McCoy and a look into the world of the Enterprise medical team.

 

 

“ _Knowing_ you’re not going to sleep well certainly doesn’t make not sleeping any better,” Christine muttered to herself as she sat awake in her quarters two hours after leaving sickbay.  Hoping to bypass the inevitable replaying of the evening’s events in her head, she had gone straight from a hot shower to the meditation corner she had set up with Spock’s recommendations.  She sank onto the cushion, lightly rested her attention on the wall and began to breathe deeply and evenly, letting the silence wash through her.  It only took four or five breaths before the silence brought the image of McCoy’s unmoving form and the deep breaths distorted into the memory of agonal gasps. 

 

Christine’s eyes flew open as she struggled to calm her racing heart.  “Get a grip, Chapel,” she chastised herself.  The doubts began to creep back in.  “What if I missed something?  Should I have done something else?”

 

“No,” Christine told her brain firmly, “we’re not going there.”  She took a deep breath in through her nose and let it out slowly through her mouth.  She refocused her attention on the wall and her breathing.  “What is it Spock always says?” she reminded herself. “Empty your mind…….” 

 

Thirty seconds later, Christine sprang to her feet, hoping that her pacing would shake the image of McCoy’s empty mind out of her head.  She shuddered at the vivid memory of a flat EEG, of lifeless eyes and a brilliant spark cruelly torn from the universe.  “Okay,” she breathed out shakily, “so emptying the mind isn’t going to work tonight.”  She briefly considered calling sickbay for an update, but didn’t want to pull anyone away from their patients.  Besides, Mara said she would call and out of all the nurses on staff, Mara was the one most capable of restraint without chemical assistance.  Christine had seen the younger nurse taken down a hallucinating security chief with her bare hands.  In one move.  She had decided right then and there that Mara was a keeper……and to never get on her bad side. 

 

Christine chuckled at the memory of McCoy’s face that day.  His eyebrows were practically in his hairline as he darted forward to administer the sedative.  Once he was sure the security chief was out, he stood up slowly, glancing thoughtfully between Mara and the unconscious man on the floor.  His face brightened.  “How are you with pigheaded Vulcans?” he grinned at the possibilities.  Christine almost had to leave the room to compose herself at the image of Mara bringing Spock down faster than a Vulcan neck pinch.

 

“To hell with emptying my mind,” she thought to herself, bringing the memory of McCoy’s impish grin and her own uncontrollable laughter to the forefront.  She focused on those positive images and feelings, basking in the happiness like a cat in the sun.  Feeling herself start to relax, Christine made her way to the bed and stretched out.  She visualized that scene over and over until the day’s doubts and tomorrow’s fears were overpowered by the sheer light of memory.  She then began to think of herself drifting to sleep in that warm light, wrapped in the comfort of laughter. 

 

Christine smiled as sleep began to take her.  “Don’t you dare make this the last one,” she warned the memory of McCoy’s grinning face.  Her eyes closed. 

 

****

 

 

Four hours later, Christine bolted upright at the whistle of the comm.  Throwing off the covers, she rushed over to the comm unit, thumbing the switch, instantly awake.  “Chapel here,” she said.

 

“Hey, Chris,” Mara acknowledged, rubbing one eye tiredly.  Before Christine could worry, she continued, “we’re just getting him settled in ICU now.”

 

Christine let out a breath.  “How’d he do?” she asked, trying to stifle her worry at Mara’s exhausted expression.

 

Mara smiled ruefully.  “He tried to crap out on us twice,” she admitted, “but a little yelling on my part, a lot of reminding him of your yelling and a few drugs later, he started to see things our way again.”

 

Christine sighed.  “Did he arrest again?” she asked bluntly.

 

Mara shook her head.  “Tried, but didn’t succeed,” she said.  She shot a glance over her shoulder.  “Damn inconsiderate of him, considering we were trying to repair his brain and all.”

 

Christine opened her mouth to ask another question, but forced herself to hold off.  Her shift started in an hour and a half and she’d get full report from Mara then.  “I’m coming down,” she said simply.

 

Mara threw her hands up in a ‘whoa now’ gesture.  “Your shift doesn’t start for another hour and a half,” she reminded her.  Knowing that wasn’t going to make a difference, she changed tactics.  Time to be honest.  “Seriously Chris,” she pleaded, “give me half an hour at least to get him settled, grab baseline labs and get some orders.”  She looked back over her shoulder again toward the intensive care unit.  “Maybe even a little longer,” she admitted, sighing heavily.  “M’Benga is still reviewing his notes from Dr. Kerebus and I haven’t worked with a central line since my History of Nursing class back at school, let alone ever had my hands on a cerebral shunt.  Just give me a chance to put together a coherent report for you, okay?”

 

Christine nodded.  She knew how frustrating it was to work with equipment or diagnoses you didn’t know while someone else was breathing down your neck for report.  “Okay,” she agreed quietly.  “You sure you don’t want me to come down and watch him while you and M’Benga finish up?” she offered.

 

Mara smiled secretively.  “Already covered,” she said.  “We weren’t the only ones monitoring him all night.”

 

Christine shook her head, smiling.  Kirk.  Of course he would have stayed.  How he was going to make it through his shift today……she caught herself with a laugh as she looked at the time and considered her own broken, far too little sleep.  _“You were saying, Chris?”_ she chuckled to herself.  She looked back at Mara.  “Okay, I’ll see you in about an hour,” she acknowledged.

 

“See you then.  Govannen out.”

 

****

 

 

Exactly one hour later, Christine Chapel walked into sickbay, giving the first room a customary sweep, checking to see who was there.  Tenzin’s bed was empty – not surprising considering how well he was doing right before McCoy’s surgery.  She figured Tom probably discharged him last night.  Only one bed had been filled from the solar flare casualties and that patient appeared to be sleeping peacefully.  Christine stole a quick look at the monitors.  Continuous cranial scan – most likely concussion treatment.  She turned toward recovery and found Elise heading her way.

 

“Mornin’ Chris,” Elise yawned, reaching the bedside and pulling up the latest numbers. 

 

“Is Lt. Brander the only one Tom admitted last night?” Christine asked, nodding at the sleeping patient.

 

“Yup,” Elise acknowledged.  “Mild concussion – M’Benga just wanted to keep him here for a few hours of cranial scanning to make sure the meds worked.  He’s been easily arousable, A+O x 3, scans normal.  Meds are finished.  I’ll be sending him back to his quarters in a few minutes.”

 

Christine nodded.  “One down,” she said.

 

“Two down, actually,” Elise corrected her with a chuckle.  “I just kicked the Lt. Commander out of here fifteen minutes ago.  He’s appendix and pain free.”

 

“Great,” Christine smiled.  It was always nice when a routine surgery was actually routine.  She headed for the desk to double-check the schedule.  “So, Tom’s back off again and…..” she called up the file on the PADD, “Jack’s on with me?”

 

“Yeah,” Elise said, “we figured you’d want Leonard and since he’s going to be a one-to-one, Jack can take whatever else comes in.”

 

“Works for me,” Christine nodded, flicking her eyes toward ICU.  She didn’t want to rush Mara……

 

“I saw that,” Mara’s voice boomed across the room as she walked out of ICU, PADD and scanner in hand.

 

“You did _not_ ,” Christine insisted, folding her arms across her chest, trying to look stern.

 

“Please,” Mara scoffed, “like I even had to see it to know you did it.”

 

Christine laughed, body deflating.  “Okay, okay,” she sighed.

 

Mara chuckled as she reached for the schedule PADD.  “M’Benga is going to grab a few hours of sleep,” she said, changing the daily physician shift box.  “He and I spoke to the Captain last night about stealing Sanchez back from Alpha III today.  The bulk of their research is done, at least enough that they don’t need any more autopsies.”

 

_“Shit,”_ Christine thought to herself, _“I didn’t even think about physician coverage_.”  Dr. Sanchez generally functioned as a medical examiner aboard the Enterprise and spent the majority of his time in the research labs, but hell, a doctor was a doctor.  They could work out the scheduling later.  She took the proffered PADD from Mara.  “Thanks for taking care of that,” she said.

 

“No problem,” Mara stifled a yawn and motioned toward ICU. “Come on, we can do full report at the bedside.  It’s about time I kicked him out for a few minutes anyway.”

 

Christine smiled and followed Mara to McCoy’s room.  “How’d he get away with staying that long anyway?” she asked Mara with a laugh.  “Usually, you’re just as good at kicking the Captain out of here as I am.”

 

Mara stopped short in the doorway as if she wanted to say something, then shook her head and continued to McCoy’s bedside.  Christine walked in, the greeting on her lips freezing as she saw the figure seated next to the bed. 

 

It wasn’t Kirk.

 

Christine cleared her throat.  “Mr. Spock,” she acknowledged, tilting her head slightly in his direction.

 

“Good morning, Nurse Chapel,” Spock greeted.  He turned to Mara.  “I presume you require privacy for your report,” he stated.

 

Christine looked down at the still figure on the biobed.  Leonard wouldn’t have turned down the opportunity to tease Spock with his own logic.  She could just hear his dry, “you presume correctly, Mr. Spock, now scat!”  She could see Spock’s eyebrow go up, his eyes roll slightly at the mysteries of McCoy’s humanity and the soft light in both men’s eyes as they went about their duties.

 

Mara didn’t take such an opportunity.  No one else could.  “Yes, Mr. Spock.  Chris can call you once she’s done with her assessment,” she offered.

 

“That would be most appreciated, Nurse Govannen,” Spock rose gracefully to his feet.  “I shall update the Captain in the meanwhile.”

 

Christine watched the Vulcan’s back as he left the room, the doors swishing softly behind him.  She whirled on Mara, her face reddening.  “You could have warned me!” she hissed, punching the younger woman’s shoulder.

 

Mara snorted back a laugh.  “And miss all that?” she grinned.  “It just made my morning.  You should see how red your face is!”

 

Christine brought her hands up to her face, feeling the heat there.  “Glad I amuse you,” she growled good-naturedly.  She turned back to the closed ICU doors.  “Did he really stay all night?” she asked incredulously.  She remembered trying to get him down to sickbay when Sarek needed surgery – it was impossible to get him off the bridge and that was for his own _father_. 

 

Mara nodded, just as surprised.  “I saw him come in from the surgery window, sometime after midnight,” she said.  “I don’t know what he said, but he somehow got the Captain to leave, then settled himself on the floor right in front of surgery and meditated until we finished.  As soon as Leonard was settled in here, he took up residence in that chair over there like a damn watchdog.”

 

Christine resisted the urge to say, “fascinating.”  Instead, she let out a soft, “wow,” raising her eyebrows. 

 

“You’re telling me,” Mara said.  She glanced down at the PADD with M’Benga’s orders and pulled up the surgical report.  “Okay, ready for the surgical report?”

 

“Go ahead,” Christine moved closer to read along with Mara.

 

They scrolled through the computer recordings taken during surgery as Mara gave the highlights.  “Okay, easy stuff first.  I set the dermal regenerator on his hands as soon as we got in there.  He had two rounds during surgery and he’s got nice, healthy granulation tissue there now.  M’Benga put him down for one more round later today.  I set him up with a bilateral ROM apparatus,” she walked over to the control panel for the devices holding McCoy’s hands, “and programmed it for a full set q1 hour for now.  Once you do the second regen round, you can knock it down to q2-3 hours,” Mara pointed out the order on the screen.

 

“Cardiac,” Mara moved on.  “M’Benga did a standard midline incision.  Direct cellular regeneration and stimulation was performed at these locations,” Mara pointed to the anatomical diagram on the PADD, “and reperfusion therapy was focused here and here,” she highlighted the arteries on the screen.

 

“The LCA and LAD?!” Christine whistled.

 

“Yeah, they were both in bad shape,” Mara confirmed.  “Most of the left side of the heart was infarcted.  We actually had to regenerate the LCA and LAD a bit first just so they would actually hold for the reperfusion.  As you can see,” she nodded back at the screen where a red box came up with a list of drugs, “this is where he first attempted to arrest again.  Once we got him stabilized and got further in the regen and reperfusion processes, he started to tolerate it pretty well.  He kept a baseline a-fib throughout surgery – we had him on the demcorzen drip at 60 an hour at first, but then he started bradying down and not responding to atropine,” she nodded again at the red box, “so we cut it down to 30 an hour, which is what he’s at now,” she motioned to the IV stand next to the bed.  “M’Benga wants him on continuous full-body perfusion scans and EKG.  He was throwing all sorts of multifocal PVCs during the last half of surgery.  I’ve got the cardiac kit and cardio stimulator at the bedside,” she tapped the box to her right.  “Latest labs show an HSNR of 2.5, so M’Benga cut the rinhepin drip down to 500 units an hour.  He behaved himself hematologically – no clotting or hemorrhage issues.”

 

Mara pulled in a breath.  “He did _not_ tolerate the direct cerebral regen well.”  She scrolled down a list of red boxes citing critical readings and emergency protocols.  “His vitals were all over the map.  Heart rate jumped from 20s to over 180, sats dropped into the 60s at one point, BP bottomed out at 50 systolic one moment, then shot up to almost 200.  Only thing that stayed stable were his respirations, but that’s because he’s on the damn vent.  Then he gave us _this_ lovely strip,” she called up an EKG rhythm strip.

 

Christine pulled her eyes from the list of life-threatening vitals and interventions and looked at the rhythm.  “Oh, God,” she breathed out. 

 

“Yeah, that’s pretty much what I said,” Mara let out a shaky laugh, “before I started in with the yelling and cursing.  I think I surprised M’Benga with a few new ones.  20 beats of v-tach, then back to a-fib in the 30s, then another 15 beats of v-tach, then a damned _30 seconds_ ventricular standstill before we got him back to an a-fib in the 60s.  I swear, he took a good two years off my life.”

 

“I’ve never seen activity like that,” Christine shook her head.

 

“Neither had I,” Mara said, “and I never want to see it again,” she directed those words firmly at McCoy.  She drew in a breath.  “Anyway, this continued until the last twenty minutes or so of the regen, then he finally stabilized again.  He actually did very well during the reperfusion and tri-ox supplementation.  We did a full thirty minutes of direct mist before placing the shunt and closing him up.  Based on his discussion with Dr. Kerebus and Dr. McCoy’s notes on possible dosing schedules, M’Benga decided to start with q2 hour doses of 60 ccs via the shunt.  I transferred the computer database’s information on cerebral shunts to text on the PADD for you, but the audio is also linked to the terminal here,” Mara pointed behind her, “in case you want audio instructions on how to use the damn thing as you work with it.  I also put the central line info in both places, since, at least for myself, it’s like traveling back in time working with this stuff.  Did you know they used to have to pull these things regularly because of infection rates?  No one could keep them in long, patients went septic half the time, then had to get new ones inserted to treat the sepsis……thank God we don’t have to deal with that anymore!”

 

Christine glanced at the subclavian line and the several IV drips hooked into the various ports.  It really was just like Leonard to take his “old country doctor” routine this far.  She seriously couldn’t remember ever having a patient on so many ancient treatments and devices.  Yet, at the same time, it was only through modern medicine that he even had a chance in his condition and it was due to his own passion and brilliance that they even had the shunt idea to consider.  Leave it to McCoy to make himself a living example of his own medical philosophy.

 

Mara met Christine’s eyes.  “Ready for the head-to-toe?” she asked.

 

Christine pulled her attention back to the PADD in her hands.  “Sure,” she confirmed, stepping closer to the bed.

 

Mara began a full report of every one of McCoy’s body systems, adding in vital signs, IV drip doses and upcoming labs and orders as they were relevant.  Christine had all the information on the PADD, but she liked to keep this routine, checking everything as it was discussed, getting a baseline from the person who had spent the last several hours with her patient, especially one as critical as McCoy.  It was extremely rare to have a one-to-one on a starship and Christine wanted to make sure she didn’t miss a thing.  She made mental notes to herself as Mara spoke.  Virdipan drip for sedation – even though he was currently unresponsive to painful stimuli and his pupils were so sluggish they were nearly fixed, there was no knowing when (“ _when_ not _if”_ she insisted to herself) he might start to wake up and they didn’t want him overtaxing his already overtaxed system.  Rinhepin and demcorzen drips to control clotting and hopefully break the a-fib.  Continuous EKG to watch for further dysrhythmias and continuous perfusion scans to monitor for clots.  IV fluids for hydration.  Vent mask in place, vent still set for AC to allow his body to completely rest – he still wasn’t attempting breaths on his own.  Bed controls set for anti-pneumonia precautions.  Anti-ileus meds given ( _“although they never really work”_ she thought), bowel sounds hypoactive, nutrition patch for IV supplementation placed on abdomen.  Urinary catheter in place, leg bag attached.  Christine made a note to change that over to an old hanging bag first thing.  They were a little more unsightly, but she liked being able to see urinary output at a glance.  Fecal catheter in place.  Skin precautions set on bed controls.  She made a mental inventory of supplies and medications she wanted to grab before starting her assessment. 

 

“M’Benga is obviously on call for the next few hours if you need anything.  Any questions?” Mara ended.

 

“I think that’s the longest report I’ve ever gotten,” Christine tried to lighten the mood.

 

Mara laughed, her face brightening again.  “It’s definitely the longest I’ve ever given!”

 

Christine smiled.  “No, no questions.  Can you just do me a favor and let Spock know that he can come back in half an hour?”

 

“You got it,” Mara stretched.  “But you have to promise to tell me what he says.”

 

“What he says?” Christine asked, confused.

 

“When you ask him why he stayed,” Mara said simply, interrupting Christine before she had a chance to deny it. “Because you know you will.”

 

Christine sighed in defeat.  “All right, all right,” she laughed.  “Go sleep.”  She grabbed Mara’s arm as she headed for the door.  “Thank you,” she said, hoping that she could somehow infuse the real depth of her gratitude into those two words.

 

Mara smiled.  “Hey, I love him too,” she said simply.  She squeezed Christine’s hand and headed for the comm to call Spock.

 

Christine tallied up her mental list and headed for the supply cabinets to grab what she needed.  Armed with the first round of medication orders, IV flushes, a hanging urinary bag, and skin and mouth care products, she returned to McCoy’s bedside, switching the ICU windows over to the opaque tint for privacy.  She turned her medical scanner over to voice-recognition charting and programmed the audio order function.  She usually only used the voice-recognition program in surgery, because it was easier to just say what she was doing out loud and have the machine chart it for her while she was trying to maintain sterility, but it was a nice option for the rare ICU patient where there was a ton to do, leaving little time for manual charting later on.  She put M’Benga’s orders on audio prompt so she wouldn’t miss a medication or treatment.  She could add her own prompts later for her preventative treatments.  Christine looked over her list and decided what to do with her first assessment of the day.  Knowing Mr. Spock, he would be timing the half hour from Mara’s call down to the hundredth of a second.  She had to use her time wisely and save the details for after Spock’s shift on the bridge started.

 

“First things first,” she said out loud, grateful that the voice-recognition charting only picked up actual medical orders and procedures.  She walked over to McCoy and planted a soft kiss on his forehead.  “Mornin’ Len,” she smiled.  “It’s just you and me for a bit, so I’m going to start your assessment.”

 

Christine spoke as she worked, mostly to McCoy.  She did her own systems assessments and voiced them to the scanner, verified the IV drips, linked the biobed monitors to the scanner for continuous upload, gave the next tri-ox treatment and switched the urinary catheter over to the hanging bag, clamping it to the pull-down bar under the bed.  She covered McCoy, cleaned up her supplies, noted the next treatment time, and untinted the windows just as Mr. Spock was walking into sickbay.

 

_“Damn, I’m good,”_ she grinned to herself as she stepped through the ICU doors.  “Go on in, Mr. Spock,” she greeted him. “I’ll be back in a moment.”

 

Spock nodded his acknowledgement and proceeded to McCoy’s bedside, settling himself, ramrod straight, in the chair he had vacated earlier.  Christine disposed of her used supplies, gathered up an extra dermal regenerator and walked back to the ICU.  She froze at the window as she saw Spock ghost a hand over McCoy’s temple, then suddenly jerk away as if burned.

 

“What’s wrong?” she rushed into the room.

 

Spock’s head snapped up as if he had missed something.

 

“You pulled away,” she motioned between Spock’s hand and McCoy’s face.

 

Spock nearly cringed.  “Dr. M’Benga informed me last night that it would be unwise to attempt a mind meld with Dr. McCoy in his current condition,” he informed her.  He paused briefly, his eyes flicking across McCoy’s face.  “I almost……forgot,” he admitted.

 

So _that’s_ what that was – Spock caught himself before he could initiate a meld.  Christine was glad M’Benga had thought of that.  They were trying to keep McCoy quiet and a meld would certainly over-stimulate his recovering cerebral tissue.  Also, Leonard wasn’t too fond of people being in his brain under normal circumstances – if he happened to realize Spock was in his mind, he could easily freak out and shut down completely and they could lose any chance of the cerebral treatments succeeding.

 

Christine nodded and began preparing the dermal regenerator.  She watched Spock out of the corner of her eye, looking for an opening.  Finally deciding he was as open as he’d ever get, she spoke.  “So, Mara tells me you were here all night,” she offered tentatively.

 

Spock’s gaze never left McCoy.  “I was not here _all_ night,” he corrected her.

 

Christine sighed.  Damn literal Vulcans.  “All right, not _all_ night,” she conceded, “but from about midnight on.”

 

“I relieved the Captain at 2338 hours,” Spock said.

 

Christine rolled her eyes to the ceiling.  “I’m sure the Captain would have stayed,” she tried again.

 

Spock’s eyes flicked in her direction for a split second before returning to McCoy’s face.  “The Captain requires rest to perform his duties,” he explained, “which he would not get here.  As I require little sleep and can meditate to restore my energy levels, it was only logical for me to take his place.”

 

“Surely it would have been more comfortable meditating in your quarters than on the floor in sickbay,” Christine pointed out.

 

Spock sighed.  “As I have attempted to teach you,” he said slowly, as if speaking to a particularly slow pupil, “meditation is not dependent on physical location.”

 

Christine cringed at the memories of her meditation attempts the previous night. 

 

Spock seemed to sense her discomfort, for he spoke up again, his tone a touch softer.  “It was my duty to monitor the doctor,” he said.

 

“Technically, that’s my duty,” Christine corrected him, “and the duty of the rest of the medical staff.”  She paused as Spock’s meaning came through.  She sighed heavily.  “You mean your duty as first officer,” she realized tiredly, “to make sure the chief medical officer recovers to perform his duties and maintain the health of the crew.”

 

Spock pulled his gaze from McCoy and met Christine’s eyes.  “My duty as the doctor’s friend,” he clarified softly, brown eyes radiating the strength of his conviction.  “And Jim’s,” he added, his voice barely a whisper.

 

For a moment, Christine couldn’t breathe.  She choked back a surprised sob as Spock slowly brought his gaze back to McCoy’s pale features.

 

Christine’s mind wandered back to the Babel conference, where she met Spock’s parents for the first time and assisted McCoy in performing Sarek’s cardiac surgery.  The day after the surgery, Amanda had come into sickbay just as Christine was about to go off shift.

 

“Ah, Mrs. Sarek,” McCoy had greeted her with a smile.  “Your husband is awake if you’d like to visit.”

 

“Actually, I’m here to steal your nurse,” Amanda smiled back.  She took Christine’s arm warmly.  “Are you up for a little girl talk?” she asked.

 

McCoy’s eyebrows shot up, a knowing grin on his face.

 

Christine shot him a look, then turned to Amanda.  “I’d be honored,” she said.

 

They had gone to the ambassador’s quarters, where Amanda had tea waiting.  They started out with small talk before Amanda came to the point.  “Please forgive my bluntness,” she laughed, “but living with Vulcans will do that to you.”  She met Christine’s eyes.  “I’ve seen the way you look at Spock,” she said gently.

 

Christine opened her mouth to protest, but Amanda waved her off.  “Please dear, it’s all right,” she soothed.  She smiled ruefully.  “90% of the time, Spock and his father make me wish I had never heard the words ‘Vulcan’ or ‘emotion,’” she sighed, then paused, her eyes drifting in memory. “But then one of them will do something so _emotional_ , so _human_ , that it just melts your heart…..and gets you through that 90% where you just want to throttle them,” she finished with a soft laugh.

 

The conversation later turned to Kirk and McCoy’s role in Spock’s life.  “They both keep him human,” Amanda smiled, “as much as Spock may hate to admit it, but McCoy…..” she trailed off, her eyes drifting again.  “McCoy will always bring him home.”

 

Christine felt a chill run up her spine.  “I don’t understand,” she said softly.

 

Amanda shrugged lightly.  “Neither do I,” she admitted. “But I know.”

 

“A mother’s intuition?” Christine offered.

 

“I suppose so,” Amanda smiled wistfully, as if recalling a future memory.

 

****

 

 

Christine pulled herself back to the present and the bonded men in front of her.  McCoy had certainly brought the human in Spock home.  Now he just needed someone to lead him home from the brink of death.  Several times over.

 

Christine turned away to rub her damp eyes.  She smiled.  McCoy had the full support and attention of the Enterprise medical staff.  He had the fiercely devoted friendship of James T. Kirk and the steadfast loyalty of Vulcan in Spock.  And hell, how many people could say they had earned the respect of Khan Noonien Singh?  McCoy had not only stood calmly with his patient’s knife to his throat, but he had pointed out the locations of the most effective arteries to cut!  Not bad for someone who proclaimed to be “just an old country doctor.”  

 

Christine drew in a deep breath, her step lighter as she placed the dermal regenerator. 

 

Maybe everything really would be all right after all.

**Notes for the Chapter:**

> Medical Notes:
> 
> \- A central line is a specialized IV line that goes in a major vein (generally the jugular in the neck, the subclavian under the collarbone, or the femoral near the groin). They generally have several ports that can be used for medications or fluids, and since the vein is larger, the vein can take larger volumes of medications or caustic medications that often harm smaller vessels.  
> \- “A + O x 3” is read as “A and O times 3.” It stands for “alert and oriented times 3.” The 3 stands for being oriented to person (knowing who you are), place (where you are) and time (the year or more specific date). This is a basic neurological assessment.  
> \- Thanks to CaTigeReptile’s review, I learned about Dr. Sanchez, from the third season episode, “That Which Survives.” Since he was only briefly in that one episode, I gave him a quick back story for this tale.  
> \- The references to Sarek’s surgery, Spock’s mother Amanda, and the Babel conference are from the second season episode, “Journey to Babel.” Amanda decided she wanted to join this story.  
> \- “q” stands for “every.” Q1 hour = “every hour”, q2-3 hours = “every 2-3 hours.”  
> \- LCA stands for “left coronary artery.” LAD stands for “left anterior descending artery.” These are both major suppliers of blood to the left side of the heart which pumps blood to the rest of the body.  
> \- “Bradying down” means the patient’s heart rate is dropping.  
> \- “Multifocal PVCs” are extra heartbeats generated by several different, irritated areas of the heart. They can lead to serious dysrhythmias, like the lethal v-tach or v-fib.  
> \- Ventricular standstill means the bottom chambers of the heart, which get blood to the rest of the body, aren’t functioning.  
> \- Christine and Amanda’s discussion on McCoy always bringing Spock home was inspired by the third Star Trek movie, “The Search for Spock.”  
> \- McCoy being awesome and standing up to Khan is from the first season episode, “Space Seed.”


	5. Chapter 5

**Summary for the Chapter:**

> McCoy is critically injured and Christine Chapel does what she does best. A character study of Leonard McCoy and a look into the world of the Enterprise medical team.

 

 

Jim Kirk strode down the corridor to sickbay, rubbing a tired hand across his face.  He knew he wasn’t _really_ going to sleep last night.  Every time he closed his eyes, he saw Bones lying on the Engineering grating; when he tried to quiet his racing thoughts, all he could hear was Christine Chapel’s terse, “he’s down, Captain.”  He had figured that spending the night in sickbay would at least give him the _illusion_ of doing something for Bones.  Kirk knew that simply feeling Spock’s or McCoy’s presence in the room when _he_ was injured gave him an extra boost of energy, so he figured he’d see if he could give back.  He remembered Nurse Chapel giving his arm a quick, supportive squeeze before she went off-shift, then settling down on the biobed directly across from the windows to OR 2.  Mara had asked him whether he wanted a headset so he could hear what was going on in surgery.  Kirk had to admit, he was tempted - at least he could feel like he knew _something_ about his friend’s condition.  But then he remembered Minara…..being able to see and hear Bones dying with that goddamn force field holding him back.  He wouldn’t be able to see Bones through the surgery windows, but being able to hear what was going on and not seeing him at the same time would probably be worse.  If he heard Bones was dying, he’d have to go to his side.  There was no other option……yet he couldn’t just barge into a sterile surgery room and put Bones at greater risk.  Kirk thought back to hearing Christine shock McCoy’s heart over the comm, screaming at the doctor to fight back.  What had Kirk done?  He had turned the conn hastily over to Spock before running to Engineering.  No, Kirk decided, it was better that someone contact him if he needed to be there.  He had turned down the headset, settled down, and focused all his energy on Bones recovering.

 

Kirk sighed, glancing up at one of the corridor chronometers.  His shift started in forty-five minutes and it certainly wouldn’t do for the Captain to be late.  He unconsciously increased his pace.  He had already contacted the Bridge, making sure there was nothing that needed his immediate attention and confirming that the Enterprise was en route to Alpha III to pick up Dr. Sanchez.  He hated to admit it, but the thought of picking up the man who generally functioned as the Enterprise’s medical examiner, with Bones in such critical condition, kind of creeped him out.  He shook off the thought.  Spock had left his quarters an hour ago, informing Kirk that McCoy had made it through surgery – that was half the battle right there.  However, when Kirk had pressed Spock for details, the Vulcan had clasped his hands behind his back and informed the Captain that the medical staff could give him a more detailed report.  It wasn’t the fact that Spock refused to give his interpretation of whatever he knew about McCoy’s medical condition that worried Kirk – Spock hated speculating on insufficient data, especially when it was one of those rare areas outside his realm of expertise.  It was the almost imperceptible slump of Spock’s shoulders, the split-second flash of concern in his dark eyes……and the soft use of his given name that put Kirk on alert.  Spock only called him “Jim” in what could be called “emotional situations.”  That one syllable spoke volumes of a worry Spock would be hard pressed to voice.

 

Kirk’s thoughts turned to his first officer.  Spock had entered sickbay an hour after McCoy’s surgery started, insisting Kirk return to his quarters and rest.  Naturally, Kirk had refused, so Spock brought out the logic.

 

“The Captain of a starship requires rest to perform his duties in a manner befitting a Starfleet officer,” Spock informed him from his place directly to the right of Kirk’s line of vision.

         

Kirk had met Spock’s eyes defiantly.  “The Captain also requires that his first officer rest sufficiently to perform _his_ duties,” he countered. “And if you’re just coming from the Bridge now, you’ve already been on duty too long.”

 

Spock let out a half-sigh.  “Captain, may I remind you, I am Vulcan.  I do not require the amount of sleep you do and I can easily perform the meditation that will enable me to competently perform my duties right here in sickbay.”

 

“You’re only half-Vulcan, Mr. Spock,” Kirk had shot back. “You have a human half too.”  Kirk waited for the inevitable comeback.  Spock’s humanity was always a touchy subject and as much as he wasn’t looking for a fight right now…..well, he kind of was.

 

There was no raised eyebrow, no acerbic retort regarding Vulcan superiority.  Spock had straightened, as if gathering the courage to break his pause.  He finally drew in a breath, fixing his eyes at a point behind Kirk’s right ear and spoke.  “You are correct, Captain,” he intoned, before swallowing almost imperceptibly and adding, “and it is not entirely…. unaffected by the current situation.”

 

 _“Way to go, Jim,”_ Kirk thought to himself.  As much as he and McCoy teased Spock about the Vulcan’s carefully hidden human half, they both knew how human Spock could be.  Of course, that didn’t stop Kirk from forgetting that fact sometimes.  Like right now.  He stood up, moving into Spock’s line of vision.  “I’m sorry Spock,” he said softly, squeezing the Vulcan’s arms lightly, “I was so wrapped up in my own worry that I forgot that Bones is your friend too.”

 

Spock met Kirk’s eyes and nodded.  All was forgiven.  “Please, Jim,” he said, as close to earnestly as a Vulcan got. “Allow me to monitor the doctor’s condition.  I will inform you immediately of any significant change.”

 

Kirk had sighed heavily.  There really wasn’t anything he could do right now and he could feel the subtle tendrils of exhaustion from the day’s events creeping up on him.  As much as he knew that wouldn’t be enough to get him to sleep, he knew he needed to try and rest anyway.  He realized that he just wasn’t used to leaving someone he cared about in anyone’s hands besides Bones’.  Whenever he or Spock were injured, he was eventually able to relax, secure in the fact that McCoy was there, taking care of them with his unique combination of biting sarcasm, old-fashioned gentle humor and that tenacious medical mind.  He remembered attacking Spock’s declaration that McCoy was dying on Minara, insisting that the Vulcan couldn’t know, that he wasn’t a doctor.  McCoy had to pipe up with his verification before Kirk would let it go.  _“Well,”_ Kirk thought to himself, _“neither Spock nor I are doctors, but Bones has the best medical team in the fleet working on him now.”_   He had to let go, to trust that Bones was in hands just as capable as his own. 

 

“All right, Spock,” Kirk had relented.  He glanced back at the tinted surgery windows.  “Keep me informed.”

 

“I will,” Spock promised.

 

Kirk nodded and turned for the door.  He looked back one more time.  “He’s going to make it,” he insisted.

 

“I do not doubt the good doctor’s stubbornness,” Spock replied, settling himself on the floor in front of surgery.

 

Kirk chuckled.  He drew in a breath, hesitated, then spoke.  “Good night, Spock,” he said quietly.

 

“Good night, Jim,” Spock answered, closing his eyes as the sickbay doors swished shut.

 

****

 

Kirk pulled himself back to the present.  He had managed to get a few scattered hours of sleep, but his brain wasn’t quite alert yet.  He had debated whether to take one of the sleeping pills Bones had prescribed for him, but those things knocked him out for hours and he didn’t want to miss anything.  He had finally decided on Bones’ other prescription, and after two glasses of Saurian brandy, he had finally managed to drift off.  He shook his head to clear the last vestiges of worry and interrupted sleep.  _“Pull it together, Kirk,”_ he ordered himself. _“You’ve got over 400 people depending on you. Bones is depending on you.”_  He looked up and realized he had reached sickbay.  Taking a deep breath, he strode inside.

 

Lt. Jack Broyer poked his head out from one of the supply rooms.  “Good morning, Captain,” he greeted. “Dr. McCoy is in ICU 1, straight ahead and to the left.”

 

“Thank you, Lieutenant,” Kirk acknowledged.  As he reached the ICU doors, Christine Chapel was walking out, a dermal regenerator in her hands.

 

“Morning, Captain,” she smiled softly. 

 

Kirk managed a smile in return.  He was glad Christine was back.  If he couldn’t have Bones on duty, Christine was a close second.  She had proven that without a doubt last night.  “Good morning, Nurse,” he responded.  His smile faded slightly.  “How is he?”

 

Christine’s smile took on a weary tinge.  “He’s stable for the moment,” she said.  “Mr. Spock is with him.  Go on in.  I’ll be back in a minute with a full report.”

 

Kirk nodded and stepped inside.  His breath froze in his chest.  He had never seen a sickbay patient look so……sick.  McCoy was hooked up to dozens of machines, several of which Kirk had never seen before.  Several IV lines ran into a place just under his right collarbone, the pumps whirring softly, flashing the names and doses of their medications.  The ventilator whooshed regularly, pushing air into the tight-fitting mask on McCoy’s pale face, raising the lax chest mechanically before pulling the air back and dropping it back down again.  The doctor’s head had been shaved, a bright white swath of bandaging securing the shunt in place.  The monitors were crammed with continuous streams of data, several scans vying for control of the tight space. 

 

“Captain.”

 

Kirk started.  His eyes tracked the room until he noticed Spock standing at McCoy’s bedside.  He forced himself to move to his first officer’s side.  “Spock,” he acknowledged, clearing his throat as he looked back down at McCoy’s still form.

 

The two men were still standing in silent, supportive solidarity when Christine came back into the room.  She nodded to them, picked up her PADD and walked to McCoy’s side.  “Okay Len, I’m back,” she said, squeezing his arm gently.  “The Captain and Mr. Spock are here.  I’m just going to fill them in, then I’ll get back to those preventatives.”

 

Spock raised an eyebrow.  “Nurse Chapel, I do not understand the logic in speaking to an unconscious man as if he were conscious.”

 

Christine shot him a tolerant glare.  “There is, in fact, medical evidence to support speaking to sedated, unconscious patients, Mr. Spock,” she informed him.  “Science may not be able to pinpoint exactly why, but there are thousands of documented cases of patients reacting to a loved one’s voice and of patients waking up and remembering things they were told while unconscious.”  She smiled softly at McCoy.  “Besides,” she added, “a good nurse always tells her patient what she’s doing and why.”

 

Spock tilted his head slightly in what passed for his ‘I still don’t understand, but then again, humans are strange’ manner.  He paused, as if calculating something, then spoke again.  “Although, if simply speaking to Dr. McCoy about daily events may produce effects similar to those of your shouting at him, I believe it would be advisable to continue,” he acknowledged.

 

Christine tried to beat back the blush creeping into her cheeks.  She forgot that Spock must have heard her yelling at McCoy in Engineering too.  Hell, the whole Bridge must have heard.  She knew Spock well enough now to recognize the rare praise in that statement.  “Thank you, Mr. Spock,” she replied, keeping most of her smile to herself.  She cleared her throat and glanced down at the PADD.  “Are you ready for report Captain?” she asked.

 

At Kirk’s nod, Christine began with the surgery report, pausing for the Captain’s questions and giving him time to digest the information.  By the time she had finished explaining the two near-arrest incidents, Kirk’s face was almost as pale as McCoy’s. 

 

Christine waited silently until Kirk indicated he was ready.  He finally pulled his gaze from McCoy’s silent face, attempting to pull on his Captain’s assuredness.  He drew in a breath.  “What’s the plan?” he asked.

 

Christine began walking him through her assessment so far that day, explaining where McCoy stood medically at the moment.  She explained the medication regimen, the scans on the monitors, her own treatment plans to keep an immobilized body as healthy as possible.  She walked over to the ventilator.  “He’s still on AC,” she said, “so the ventilator is doing all the work for him.  If he tries to take a breath on his own, the ventilator will take over and give him the prescribed volume and percentage of oxygen.  Dr. M’Benga is going to switch him over to SIMV tomorrow.  With that setting, if Leonard attempts to take a breath, the machine will back off and allow him to take in his own volume of air.  That will allow us to monitor the strength of his respiratory function and assist us in knowing when to try him off the ventilator.”  She met both men’s eyes.  She was not one to hide bad news and they were not ones to suffer those who did.  “Now, he hasn’t tried to breathe on his own yet,” she clarified, “but it’s still early.”

 

Kirk opened his mouth to speak, but was cut off by the quiet pinging of the monitor. 

 

Christine moved to the screen and frowned at the flashing yellow indicator.  She grabbed the medical scanner and double-checked the reading, before scrolling down the PADD, looking for an order.

 

“What’s wrong?” Kirk finally asked.

 

“His blood pressure is a little lower than I’d like,” Christine explained, still focused on the PADD.  Her eyes lit up as she found what she was looking for.

 

“What does that mean?” Kirk prompted.

 

“Sorry, Captain,” Christine apologized for her lack of explanation.  “I was just looking for an order.”  She met his eyes reassuringly.  “Dr. McCoy is on intravenous fluids right now to build his system back up after surgery and the arrest,” she explained, “but it may not be enough.  Regulating IV fluids with cardiac damage can be a little tricky, because you don’t want to stress the heart too much with having to pump all that fluid around, yet you need to keep the body hydrated.  There are two ways to treat low blood pressure in Dr. McCoy’s case – one is to give vasopressors, a class of medications that constrict the smaller blood vessels in the body, bring up blood pressure and shunting everything to the core.  We don’t like to do that unless we’ve ruled out a fluid deficit though, in which case we generally give a bolus of fluid first, to see if that helps.  I was looking to see if Dr. M’Benga left instructions for those options, and he did.  I’m just going to go get an extra bag of fluid.  I’ll be right back.”  She silenced the alarm and moved swiftly to the door.

 

“Bones….” Kirk warned the still figure on the biobed, gripping his arm tightly.  “Don’t even think about it.”

 

Christine came back in, a liter bag of fluid dangling from her fingertips, extra IV tubing balanced with the PADD in the crook of her arm.  She nodded to Kirk and Spock as she walked to the IV stand and began setting up the extra fluid rate.  Once the fluids were running, she walked back to the monitor, adjusted a reading, then dropped into a crouch at the bedside, frowning slightly at the bag hanging on the bar there.

 

“What are you looking for?” Kirk asked.

 

Christine adjusted the tubing leading to the bag before standing up and jotting a measurement on the PADD.  “That bag measures Dr. McCoy’s urine output,” she explained.

 

“I’ve never seen that before,” Kirk noted.

 

“Usually, it’s hidden under the covers, strapped to the patient’s leg,” Christine said, “but I like to be able to see the output at a glance when I’m in the room.  I guess I’m old-fashioned that way.  Blame Leonard,” she chuckled.

 

Kirk laughed softly.  “Is something wrong?” he grew serious again.

 

“Generally, we want to see at least 30 ccs of urine being produced an hour,” Christine explained.  “I noticed that Dr. McCoy hasn’t produced urine at that level yet, and I was going to keep an eye on it for another hour or so.  Like the low blood pressure, it can be normal after surgery.  The body can take some time waking up again, including the kidneys.  Giving him the extra fluids now is actually just what I need to see if he starts to pick up again.”

 

Kirk nodded, eyeing the monitor warily.  His eyes moved to the shunt.  “When will we know if the tri-ox is working?” he asked.

 

“Not as soon as any of us would _like_ to know,” Christine muttered, taking heart from Kirk’s surprised chuckle.  “Dr. M’Benga doesn’t want an EEG done for forty-eight hours.  He feels that should be enough time to see any results.  In the meantime, we are going to continue with daily sedation vacations to see if he’s ready to wake up.”

 

“‘Sedation vacation,’ Nurse?” Spock inquired.

 

“Yes, Mr. Spock,” Christine smiled.  “It’s when we turn off the IV sedation, giving the patient a chance to wake up.  The medication has a very short half-life, so we can start and stop it quickly as needed.  We’re keeping him on the sedation in the meantime for two reasons.  One is that if he did start waking up and became anxious, he could injure himself.  The other is that the medication provides a certain level of amnesia.  We figure most patients don’t want to remember some of the stuff they go through in ICU, like not being able to breathe on their own.  Since we don’t really know what’s going on in Leonard’s brain right now, Dr. M’Benga thought it was best to keep to the usual sedation protocols.”

 

Kirk looked up.  “Are you able to schedule those sedation vacations?” he inquired hopefully.

 

Christine smiled.  “I’ll make sure you’re contacted before we begin the procedure, Captain,” she assured him.

 

Kirk nodded his thanks. 

 

Spock looked up at the chronometer.  “Captain, with your permission, I will meet you on the Bridge,” he said.

 

Kirk looked up and swore softly.  Their shift started in fifteen minutes.  “I’ll come with you, Spock,” he said, pulling his eyes from McCoy’s face.

 

“I believe there is sufficient time for you to tell Dr. McCoy that you will ‘see him later,’” Spock informed him.

 

Kirk smiled.  “All right, Mr. Spock,” he laughed.  “I’ll meet you there.”

 

Spock nodded, then turned to Christine.  “Nurse Chapel, may I suggest giving the Captain a moment alone with the doctor?”

 

Christine started.  “Of course, Mr. Spock,” she replied, surprised.  At his gesture, she preceded him through the ICU doors.

 

Once outside, Spock turned to Christine.  “You have acted most competently, Nurse Chapel,” Spock began, clasping his hands behind his back. 

 

Christine almost choked.

 

“The Captain has told me of your……somewhat unorthodox methods in treating Dr. McCoy,” he continued, “and I am told that he owes his current state to your care.”

 

Christine managed to find her voice.  “I’m certainly not the only one who has been treating Dr. McCoy,” she said.  “There are a lot of people dedicated to his recovery.”

 

“Nevertheless,” Spock said, glancing over his shoulder to the image of Kirk gently resting his forehead to McCoy’s, “you do him honor by your actions, Christine.”

 

Christine nearly went into arrest herself.  Spock had not only given her the highest praise she could imagine, but he had called her by her first name.  He had _never_ called her by her first name.  She could count on one hand the number of times she had heard Spock call the Captain “Jim” and she wasn’t sure she ever heard him call Leonard by anything other than his title.  She took a steadying breath.  “Thank you, Mr. Spock,” she said sincerely, tilting her head respectfully to one side.

 

Spock met her gaze and tilted his head slightly in the same direction in acknowledgement before nodding and moving to the main sickbay doors.

 

Christine stared at the doors for a full thirty seconds before picking her jaw up off the floor.  _“Am I hallucinating?”_ she asked herself with a chuckle.  _“Hell, I don’t care – it feels too damn good!”_ she decided, determined to bring that smile back into Leonard’s room.  The PADD beeped in her hands, reminding her that the next tri-ox treatment was due in half an hour.  Christine grabbed the syringe from the medication cabinet and reached McCoy’s room just as Kirk was walking out.

 

“When are you doing the first sedation vacation?” Kirk asked.

 

“Probably toward the end of my shift tonight, once Dr. M’Benga is back on duty,” Christine informed him.  She smiled.  “I’ll be sure and contact you before we start.”

 

Appreciation flashed across Kirk’s face.  “Thank you, Chris,” he took her hands gently.

 

Christine squeezed back.  She hoped her eyes would convey her feelings because her mouth just couldn’t put everything into words at the moment.  It must have gotten through, because Kirk nodded once before striding purposefully for the Bridge.

 

Once the sickbay doors swished shut, Christine walked back into McCoy’s room and began gathering supplies for her next round of treatment.  She checked the fluid bolus that was still infusing and stole a quick glance at the urinary bag.  She added an audio reminder to herself on the PADD to check the output again in two hours before walking to the monitors and calling up a side screen.  She scrolled down to the GFR reading and programmed a set of readings over the next two hours.  Satisfied, she returned to her supplies, picking up the scanner and another dose of anti-ileus meds.

 

“Leonard, you won’t _believe_ what just happened,” she laughed as she ran the scanner over McCoy’s abdomen.  She wasn’t surprised to find the initial dose of anti-ileus meds hadn’t worked – it usually took a few doses.  She administered the hypo, telling the voice-recognition charting program what she had just done.  “Spock just complimented me!” she said unbelievingly as she reached for the skin sealant.  The biobeds were made to help prevent the common ravages of prolonged immobility – there were settings to avoid vent-associated pneumonia and skin breakdown, as well as range of motion devices, such as the ones on McCoy’s hands at the moment.  Even with all that though, the human body just wasn’t made to be in a bed for any length of time.  Christine had developed her own supplementary system, gleaned from modern and historic medicine, to decrease the chances of significant skin breakdown or atrophy.  She tinted the windows, loaded the skin sealant device, and pulled back the covers, turning McCoy carefully to one side.  As she sprayed the skin-strengthening mist over McCoy’s body, she took care to focus on the scapulae, sacrum, and heels – notorious locations for pressure ulcers.  Mara had shown her pictures of a sacral pressure ulcer from one of the miners she had treated on Omega II.  The man had been in a regular bed for a month before the family turned him over one day to find a gaping hole in his sacrum.  Even before debridement, Mara said she could put her entire fist into the wound, halfway up her forearm.  Christine didn’t want to take chances.  She knew McCoy was going to be immobile for awhile, so in addition to the bed’s changing pressures and turning/repositioning functions, she liked to use the skin sealant as a preventative.  It worked great for strengthening damaged skin and sealing minor wounds, but it also proved to be quite effective when used as a total body mist in strengthening skin against friction from bed linens and the pressure of prolonged immobility.

 

Christine turned McCoy back over and began misting the front of his body.  “I know, I know,” she could visualize his shocked expression, “and I verified that I was really awake at the time,” she added with a grin as she finished the skin sealant, covered him back up and moved to the IV pump to check the regular fluid rate, taking down the empty bolus bag and tubing.  “He actually called me Christine,” she whispered conspiratorially, wishing she could see those eyebrows go up in disbelief.

 

She gathered the bandage supplies and tri-ox and began undressing the shunt.  “He thinks very highly of you,” she said softly, reaching the device and administering the medication.  She sighed at his bald head as she began redressing the shunt site.  “Not that I don’t find bald men attractive,” she prefaced, “but as soon as this shunt comes out, you’re getting a follicular regen.”  She secured the bandage and laid a hand gently on McCoy’s head, wishing she could run her hand through his hair.

 

Christine stood up, stretching her aching back.  She grabbed the mouth care foam from the supply tray and perched back on the side of the bed.  Pulling down the side panels on the mask, Christine sprayed the light foam onto a gloved finger and applied it to McCoy’s gums, teeth and tongue.  The last thing he needed was an opportunistic infection from lack of dental hygiene while he was out.  The foam killed bacteria and fungi while also creating a protective sealant over the areas it was applied to that lasted for twelve hours.  “I’m not sure what this stuff tastes like,” Christine sniffed the tube suspiciously, “but I guess it’s better than the alternative,” she shrugged at McCoy.

 

Christine stood up and began her next head-to-toe, calling out the assessment data for the charting system to record.  She had just reached the last of the monitor data when the comm buzzed.  She strode over to the terminal and toggled the switch.  “Chapel here,” she stated.

 

“Uh, hi Nurse Chapel,” came a familiar voice, “this is Ensign Tenzin.  I was just wondering if I could visit Dr. McCoy for a few moments.”

 

Christine smiled at McCoy.  “Looks like you get a break from my voice, Len,” she grinned at him.  She turned back to the comm.  “Of course, Ensign,” she replied, “just give me a minute to finish up.  I’ll be right there.”  She cleaned up her supplies, double-checked her orders and headed for the door.

 

Tenzin bolted to his feet as she approached.  “I’m sorry if I interrupted anything,” he apologized by way of greeting.

 

Christine waved off the apology.  “I was just finishing,” she assured him.  She looked down at his knee.  “Did Jack do your follow-up?” she asked.

 

“Yep,” Tenzin grinned, bouncing on the injured knee, “good as new.”

 

“Any residual pain?”  Christine knew Jack would have asked that as part of the follow-up, but she couldn’t help herself.

 

“Feels like nothing ever happened,” Tenzin smiled before his face turned serious. “Thanks to you and Dr. McCoy.”

 

“We were just doing our jobs,” Christine said softly.

 

“Yeah, well just doing your job can be pretty amazing sometimes,” Tenzin insisted.  “Thank you.”

 

“You’re welcome,” Christine smiled.  She jerked her head toward ICU.  “Go ahead in – I’ll be right at the desk here if you need anything.”

 

Tenzin nodded and stepped tentatively into ICU.

 

 *****

 

Christine was comparing the tri-ox notes M’Benga had taken during his conversation with Dr. Kerebus with her recently rediscovered copy of the notes she and Leonard had taken during their review of the study when her PADD beeped.  She started, looking up at the chronometer.  It had been almost two hours since she had left ICU.  Jack had grabbed her to assist with a few patients and then with the research she was doing, she had forgotten all about Tenzin.  She made a quick stop at the medication cabinet, then walked into McCoy’s room.

 

Tenzin was sitting quietly on the floor next to the IV pump, legs crossed, eyes closed, breathing deeply.  He looked up quietly at Christine’s entrance. 

 

“Have you been taking lessons from Mr. Spock?” she asked the Ensign, motioning to his meditative posture.

 

Confusion flashed across Tenzin’s face briefly, before understanding set in.  “No ma’am.  This is the Buddhist practice of tonglen,” he clarified.

 

Christine moved toward the monitors, checking a few readings while keeping half her attention on Tenzin.  She had forgotten he was Buddhist.  “I’m not familiar with that practice,” she said.

 

Tenzin smiled, looking back at McCoy.  “It’s a practice of great compassion, to relieve suffering” he said softly.  “I breathe in Dr. McCoy’s pain, suffering and injuries and I breathe out relief, peace and healing…..I take in his suffering to relieve him of some of the burden, leaving room for him to take in the healing energy I send back out.”

 

Christine swore softly at the monitor.  The GFR readings were up and it wasn’t good.  She turned to Tenzin – she really wanted to discuss the practice further – it sounded like a meditation she could really work with, one that appealed to her humanity.

 

Tenzin must have caught the flash of interest on her face.  “I can send you some information on the practice,” he offered, his face split between the openness of sharing and worry at Christine’s expression.

 

The monitor began beeping wildly, flashing yellow.  “I’m sorry, Ensign,” Christine rushed to his side, bending down to confirm a reading on the urinary bag hanging there, “but I need you to step out.”

 

“Of course,” Tenzin said nervously, eyes flicking to the monitor and back at Christine’s tense face.  “Is there anything I can do?”

 

“Get Jack in here please,” Christine said tersely.

 

Tenzin placed both palms together, bowed deeply to McCoy and rushed out the door.

 

Christine hit the alarm silence button with a growl as she knelt back down and manipulated the tubing to the urinary catheter.  “Dammit, Leonard,” she sighed.  His BP was holding at the low edge of normal, but the bolus hadn’t done anything for his kidneys.  He was barely putting out 10 ccs an hour.  She was checking the perfusion scan when Jack ran in.

 

“What’s up?” he asked, eyes sweeping the room to see what was going on.

 

“No clots in the renal vasculature,” Christine muttered to herself.  She pointed to the GFR readings and then motioned to the urinary bag.  Jack took one look at the data and swore.  “You want me to draw a renal profile?” he asked, already moving to the supply tray to gather equipment.

 

“Please,” Christine acknowledged, grabbing a set of vitals and carrying the PADD over to the comm.  “Chapel to M’Benga,” she hailed the doctor.

 

A moment later, M’Benga’s face appeared on the screen.  One look at Christine’s expression and he immediately sat down, grabbing his boots.  “Report, please,” he ordered.

 

“He’s in renal failure,” Christine launched into her assessment data, “UO was down this morning, but he ended up getting a liter bolus for a hypotensive episode, so I was hoping that would work.  GFR readings for the last two hours have been borderline, but this last one is way down.  Current output’s only averaging 10 ccs an hour, vitals stable for the moment, BP is borderline hypotensive, but adequate.  Perfusion scans are clean, no clots in the renal vasculature.  Jack’s drawing a renal profile now.  The results should be up by the time you get here.”

 

“I’m on my way,” M’Benga was already on his feet.  “M’Benga out.”  The screen went black.

 

Jack slapped a pressure bandage on McCoy’s arm and dashed to the lab with the blood.  Christine stalked to the equipment closet in the corner of ICU and grabbed a dialysis machine, wheeling it to the bedside.  She viciously tore open a new package of transcutaneous pads and attached them to the machine before turning it on and priming the system.  “ _Dammit,_ Leonard,” she swore. 

 

M’Benga strode in, grabbing the proffered scanner from Christine.  He raised his eyes at the old-fashioned urinary bag, but nodded appreciatively at Christine’s foresight.  Jack rushed in, a PADD in his hands.  “BUN and creatinine way up,” he said breathlessly, tossing the PADD to Christine.  She scrolled through the results and swore, handing the device to M’Benga. 

 

M’Benga was silent for a minute before he began recording new orders.  “Start transcutaneous dialysis,” he ordered.  “Regular parameters to start.  I’ll write up the orders.”

 

Jack tinted the windows before moving to Christine’s side to help place the dialysis pads and start the machine.  “Dammit, Len, this is not behaving yourself,” she growled, turning McCoy to Jack’s side of the bed and pressing the pads firmly in place over his kidneys.  They gently turned him back over and applied the frontal pads.  Once the machine was functioning, Christine moved to M’Benga’s side, taking several deep breaths to calm herself down.  “Next set of labs?” she asked.

 

“Four hours, please,” M’Benga replied, eyes still focused on the PADD.  “Then q2 hours until we see an improvement.”

 

Christine sighed.  “You want to push the first sedation vacation to tomorrow morning?” she inquired.

 

“I think that would be wise,” M’Benga said, glancing at McCoy.  “It would be unreasonable to expect him to wake up after this added complication.  We’ll do one tomorrow morning, then schedule the others from there.”

 

Christine nodded.  “You want me to call the Captain?”

 

“Please,” M’Benga said, scrolling through Christine’s assessment data so far that shift.  “I’ll be ready to speak to him by the time he comes down.”

 

Christine steeled herself for what was going to be a very worried James T. Kirk.  “Sickbay to Bridge,” she hit the comm switch.

 

“Bridge.  Kirk here.”  Damn, she could already hear the nervous edge to his voice.

 

“Captain, could you please come down to sickbay for a moment?  Dr. McCoy is all right, but there’s been a change we’d like to discuss with you.”  She made sure to specify that McCoy was stable first.

 

Kirk sucked in a breath.  “On my way,” he said tersely before the connection cut off.

 

Two minutes later, Kirk practically ran into sickbay.  Christine met him at the ICU doors.  “What happened?” Kirk demanded.

 

Christine led him into the room.  “Dr. M’Benga will go over everything with you,” she assured him.  “He’ll be back in a moment.”

 

Kirk’s eyes fell on the dialysis machine, his shoulders slumping visibly.  “That bolus thing didn’t work?” he asked softly.

 

“I’m afraid not, Captain,” Christine replied.  “He’s in what’s called acute renal failure, most likely from the prolonged lack of blood flow during cardiac arrest.”

 

Kirk suddenly turned on her.  “I suppose this is normal too?” he spat.

 

Christine bristled.  She had heard Kirk talk to McCoy that way, particularly when Spock was injured.  She understood it was just his worry, fear, and the stress of being unable to act to fix the situation, combined with a severe lack of thinking before he spoke in a fit of emotion.  Leonard usually took the outbursts in stride and Kirk would inevitably apologize later on, but it sure as hell didn’t mean Christine was going to put up with that crap.

 

“No _sir_ ,” Christine spat back.  “Normal in his case would be _dead_.”

 

Kirk’s eyes widened.

 

Christine sighed, visibly deflating.  “I’m sorry, Captain,” she said tiredly, “but you try being dead for that long and see how well _your_ body does.”

 

Kirk swallowed hard.  “I’m sorry, Chris,” he said softly.  “I was out of line.”

 

“Yeah, but I understand,” Christine accepted the apology as M’Benga walked in.  She stepped aside as M’Benga gestured Kirk to a seat at McCoy’s bedside and began explaining the situation.  She grabbed her PADD and began amending her assessment schedule, checking the new orders and starting to mentally prepare report for Mara that evening.  Kirk slumped upon hearing that the sedation vacation was being moved, but she saw the understanding in his eyes.  She knew how he felt.  She wanted to try to wake McCoy up just as fast as he did.

 

Kirk finally stood up, shook M’Benga’s hand and leaned down to whisper something in McCoy’s ear.  He straightened back up with a half-smile on his face and said out loud, “I’ll see you later, Bones.”  He walked over to Christine.  “Keep doing what you’re doing,” he said sincerely.

 

“I’ll take care of him,” Christine promised.

 

Kirk nodded and returned to the Bridge. 

 

Christine turned to M’Benga.  “Well, that sucked,” she breathed out.

 

M’Benga actually snorted back a laugh.  “Yes, it did,” he agreed.

 

Christine laughed as M’Benga left the room.  She returned to McCoy’s side.  “Well Leonard, it’s just you and me again,” she sighed, grabbing the PADD.

 

*****

 

Several hours later, Christine was finally leaving sickbay, her shift over for the day.  Kirk and Spock had stopped in again right before report.  She had started going over the new orders with Mara at the desk, trying to give the two men as much time with Leonard as possible before she had to kick them out for the head-to-toe.  Their presence was just as important, if not more so, as the medications and equipment surrounding him in ICU.  She handed the most recent renal profile results to Mara, going over the lab schedule for the younger woman’s shift.  McCoy’s kidney values were still crappy, but at least they weren’t worse.  He had only been on dialysis a few hours, so the fact that he was holding steady was promising.  Christine finally shooed Kirk and Spock from the room and finished report with Mara. 

 

“I’ll be back on in the morning,” Christine yawned, handing the PADD to Mara.

 

“I’ll keep him in line for you,” Mara grinned, scrolling through the orders to plan her first assessment.

 

Christine smiled.  “You better,” she chuckled.  She leaned over and kissed McCoy’s forehead.  “Be good.  I’ll see you in the morning.”

 

“Night, Chris,” Mara waved as she headed for the doors.

 

“Night, Mara,” Christine replied.

 

*****

 

Christine trudged into her quarters, heading directly for the shower.  She let the hot water wash the day from her body, trying to clear her mind which was already planning tomorrow’s assessments and procedures.  “Shut up,” she growled at her brain, ducking her head back under the scalding stream.

 

Dried and dressed, Christine shuffled into the bedroom.  Her comm was blinking.  She hadn’t heard it ring since she got back from sickbay, but she was still wary as she played the message.  A smile blossomed across her face as Tenzin’s voice came over the speakers, followed by several short texts.  He had sent the tonglen information.

 

As she began scrolling through the history and explanation of the practice, Christine suddenly had an idea.  She paused the message and called sickbay.

 

“Govannen here,” Mara answered.  She took one look at Christine’s face and sighed.  “Would you go to sleep?” she demanded good-naturedly.

 

Christine made a face at her.  “I am,” she promised.  “Just do me a favor?”

 

“Sure, what’s up?”

 

“In Leonard’s office, on the shelf to the left of the desk, there’s a holo of his daughter,” Christine said.

 

“Yeah, I know it,” Mara replied, trying to figure out where Christine was going with this.

 

“Can you put it in ICU with him?” Christine asked softly.

 

Mara grinned.  “Why didn’t I think of that?  What better positive energy than Johanna watching over him with that big smile?”

 

Christine grinned back.  “I figure, the way he lights up every time he looks at her.….maybe just having it in the room will get through to him somehow.”  She shrugged self-consciously.  “I don’t know.”

 

“It’ll work,” Mara insisted.  “I’m doing it right now.  Night, Chris,” she grinned and bounced off toward McCoy’s office.

 

Christine let out a breath.  “Okay, Leonard,” she thought to herself, “no more excuses.  You’ve got the entire sickbay staff rooting for you, Kirk and Spock are ready to take up residence in your room just to support you through this mess, Tenzin is giving you his peace and healing thoughts, and Johanna is right next to you, at least in spirit.”  She turned back to the comm screen and picked up her reading on tonglen.

 

“Now let’s see how I can breathe out enough healing energy to fix your sorry ass,” she grinned.  Christine glanced over at the meditation corner.  There wouldn’t be any empty minds tonight.

**Notes for the Chapter:**

> Medical Notes:
> 
> \- The discussion on Minara refers to the third season episode, “The Empath.”  
> \- AC stands for “assist control.” SIMV stands for “synchronized intermittent mandatory ventilation.” These are the names of the ventilator settings Christine describes.  
> \- GFR stands for “glomerular filtration rate.” This is a lab value used to determine a patient’s level of kidney failure.  
> \- BUN and creatinine are two blood values used to determine how well the kidneys are functioning.


	6. Chapter 6

**Summary for the Chapter:**

> McCoy is critically injured and Christine Chapel does what she does best. A character study of Leonard McCoy and a look into the world of the Enterprise medical team.

 

 

Christine Chapel woke with a strange feeling in her gut.  She stretched slowly, letting her mind wander over the churning, trying to place it.  Although she had stayed up much later than she had planned last night, she felt oddly refreshed - her first journey into tonglen had been a success. _“Well, at least for me,”_ she thought, hoping Mara’s report would show her that it had done something for Leonard too.  She stood up slowly, stretching her back, and walked to the bathroom to splash some cool water on her face.  McCoy may have needed a strong cup of coffee to start functioning in the morning, but Christine found the soothing shock of a handful of water just as effective.  She raised her dripping face to the mirror and broke into a surprised smile at the renewed confidence she found in the eyes looking back at her.  All at once, she placed that gut feeling – excited anticipation.  Something good was on the horizon, she just knew it.  It had been so long since she had felt something so positive, that she literally hadn’t recognized it at first.  She threw on her uniform, pinned her hair back and rushed to sickbay.

 

Mara greeted Christine at the ICU doors with a smile.  “Morning, Chris.  He behaved like a perfect gentleman,” she grinned.

 

Christine let out a relieved sigh.  “As he should,” she grumbled good-naturedly, peeking past Mara through the ICU windows.  Spock was sitting at the bedside, one hand lightly gripping McCoy’s forearm, the other resting gently on the doctor’s chest.  Spock’s eyes were closed, the soft concentration in his face seemingly a mix of willing his own strength to McCoy while simultaneously comforting himself by the beating of his friend’s heart.  Christine turned away, feeling like an intruder.

 

Mara nodded, understanding.  “I know.  He’s been like that for the last hour.  I almost called M’Benga, just to check, but Sanchez felt comfortable enough that it wasn’t a mind meld and that if Mr. Spock really _was_ trying to give Leonard some strength, to let him.  He sure as hell needs it.”  She looked back at Christine and gestured toward the desk.  “Come on, we can start report out here.  I promised Mr. Spock he could have another few minutes.” Mara paused and rolled her eyes.  “Of course, he informed me that ‘a few minutes’ was hardly a precise frame of reference, so I gave him fifteen minutes and told him he’d have to count it down himself.” 

 

Christine chuckled and took a seat as Mara perched herself on the corner of the desk and began scrolling through the PADD.  “I think he knew how ready I was to kill him after that surgery,” Mara began, “because he kept quiet all night.  We maintained the dialysis settings and his renal profiles are starting to improve.  Last labs were an hour ago and he’s getting closer to the normal range.  UO is coming up – 20 ccs an hour for the last half of the shift, pushing closer to 25 the last hour.”

 

Christine nodded as she scrolled through the labs, encouraged.

 

“Sanchez figured we might as well keep the q2 labs until M’Benga reevaluates dialysis later,” Mara continued, “and he left the vent settings and sedation for you guys to work out.  The only thing he changed was the nutrition patch.”  Mara pointed to a set of labs on the screen.  “Potassium was starting to climb a bit, but with the dialysis going, Sanchez figured we could get away with decreasing the patch potassium first, rather than going right for a binder.  Cardiac status remained unchanged and he’s already dropped half a point.”

 

Christine noted the order and filed the numbers in her head, to compare to her next set of labs. 

 

“Otherwise, assessments and meds are pretty much the same,” Mara said, giving Christine a quick verbal rundown.  “You want to do a bedside?”

 

“No, I think I’m good,” Christine said, taking the PADD and double-checking the new orders.  “I might as well get started.”

 

“Nurse Govannen, Nurse Chapel,” Spock nodded to the two women as he strode out of ICU, neatly stepping to the right to avoid running into Captain Kirk as he came through the main sickbay doors.

 

Mara laughed.  “Yeah, you might want to get started.  I’ve already gotten a few calls from people who want to stop by and see Leonard today.”

 

Christine smiled.  _“Good – the more positive energy, the better,”_ she thought.  She turned to Kirk, who had stopped in front of her with questioning eyes.  “Give me ten minutes to do a quick assessment, Captain,” she said, already walking toward ICU, “then, as long as you don’t mind me working around you, he’s all yours.”

 

Kirk nodded and stepped aside as Christine walked through the ICU doors and tinted the windows.  “Good morning, Len,” she greeted McCoy, planting a quick kiss on his forehead.  “You’re a popular man today, so I’m going to start with a quick assessment.  Mr. Spock just left and the Captain is waiting outside.  He’s probably already pacing,” she chuckled softly, “so we’ll just have to rework our schedule a bit.”

 

Ten minutes later, Christine poked her head out and motioned Kirk into the room.  “I’m just going to grab some things for his first treatment,” she said.  “Go ahead in.”

 

Kirk walked nervously into the room, eyes flicking over the monitors and machinery, trying to see if anything had changed, even though he knew he would have been called if there was an emergency.  He finally walked to McCoy’s side and rested his hand on the doctor’s arm.  “Hey, Bones,” he said, trying to sound confident over the crack in his voice.

 

Christine walked back in to find Kirk standing there, staring down at McCoy’s pale face.  She gathering the tri-ox and bandage supplies and walked to Kirk’s side, nudging the chair closer.  “Sit, Captain,” she offered soothingly.  She turned her focus to McCoy.  “Okay, Leonard,” she smiled.  “Tri-ox time.  You know the drill.”

 

Kirk watched, fascinated, as Christine unwound the bandaging, administered the medication and rewrapped the site, all the while keeping up a steady stream of conversation, as if Bones were awake and talking back.  Kirk swore Christine heard his thoughts, because she met his eyes as she turned from her task and smiled softly.  “It’s okay to just _talk_ to him, Captain,” she assured Kirk.  “It doesn’t mean you’re losing a grip on reality……you’re grounding him.  Leonard has done it for _you_ more times than I can remember and it _works_.  It doesn’t have to be anything profound – just remind him he’s still here.”

 

 _“Remind him he’s still here,”_ Kirk repeated to himself.  He felt a small smile forming.  He could do that.  He started slowly, filling McCoy in on their next assignment, and soon found himself moving smoothly into their usual, teasing banter.  “More flare cataloging,” Kirk grinned at his friend.  “Someone tells me you have a highly educated medical recommendation to share with Starfleet on that one,” he smirked.

 

Christine snorted back a laugh from the other side of the bed, where she was gently moving McCoy’s legs through range of motion exercises.  While the bed encouraged blood flow to all parts of the patient’s body, that wouldn’t prevent muscle atrophy.  The ROM devices were still working on McCoy’s hands, but the rest of his limbs needed to keep moving as well.  She finished the legs and moved to the arms.

 

“The Bridge just isn’t the same without you, Bones,” Kirk sighed.  “All this flare calculating…..I literally have nothing to do.  You usually save me from the soul-crushing boredom.  I can’t tease Spock nearly as well alone,” he chuckled, “and while you know he’ll never admit it, I think he misses your…..” Kirk paused, searching for the right word. “…. _discussions_ as well.  If there was ever a time we could use some of those ‘colorful Southern metaphors’, it’s right now.”  He glanced up at Christine, who had moved to applying some sort of foam to McCoy’s mouth.  “What’s that?” he cocked an eyebrow at the tube in her hands.

 

“It kills bacteria and fungi in the mouth.  The last thing Leonard needs right now is an infection from lack of dental care,” Christine responded.

 

“Can’t you just give him antibiotics to prevent that from happening?” Kirk asked.

 

“Even with modern medicine, antibiotics are still hard on the kidneys, Captain,” Christine explained, “and we don’t want to stress Leonard’s kidneys any more than they already have been,” she nodded toward the dialysis machine.

 

Kirk nodded, understanding.  His eyes drifted in thought and his brow furrowed.  “I don’t remember any of this being done when _I’ve_ been stuck in here,” he thought out loud.

 

Christine smiled patiently.  “That would be because you were _unconscious_ at the time,” she chided sarcastically.

 

“Oh.  Right,” Kirk reddened.  He cleared his throat with an embarrassed grin and turned back to McCoy.  “See, Bones?  She really _is_ turning into you,” he smirked.

 

Christine rolled her eyes, checking some readings on the monitor as she reached for a syringe and blood tubes. 

 

“Well….a prettier version of you,” Kirk clarified, still smirking.

 

“Honestly, Leonard, I don’t know how you put up with him,” she muttered under her breath as she disinfected one of the central line lumens and began drawing the next set of labs. 

 

“Well, I believe my work here is done,” Kirk grinned at McCoy, squeezing his arm.  “I’ll see you later, Bones.”  He turned to Christine, his expression serious.  “You’ll let me know what the plan is?” he half-asked, half-ordered.

 

“Of course, Captain,” Christine responded.  “Dr. M’Benga should be here any min-“ she stopped in mid-sentence as M’Benga came walking through the door.  “Well, _now_ ,” she clarified with a chuckle.  “He’ll reevaluate Leonard and we’ll call you with the plan.”

 

Kirk nodded his thanks, gave M’Benga a quick greeting and left for the Bridge.

 

M’Benga turned to Christine with a hopeful look in his eyes.  “Dr. Sanchez and Mara informed me that Leonard did well last night,” he said, searching Christine’s eyes for anything new that may have changed that fact.

 

Christine nodded, handing M’Benga the PADD with the evening labs and interventions in addition her own morning assessment and treatments.  “I just drew the next labs,” she gestured to the vials in her hand.  “I’ll get them running while you look him over.” 

 

Ten minutes later, Christine walked back into ICU, a spring in her step as she waved the results.  M’Benga called up the information on the PADD in his hands and smiled – GFR was low normal, BUN and creatinine had finally dipped back down into the high normal range and his electrolytes were fairly steady.  The potassium was still up a bit, but it was definitely coming down and there were no changes to the EKG – McCoy was still in a-fib, but it was rate-controlled and there were only occasional multifocal PVCs – no bigeminal or trigeminal patterns and no runs.  Finally, some good news.

 

“You want to change the labs?” Christine asked, trying and failing to hide the relieved grin on her face.

 

“Yes, please.  Keep the dialysis going for the rest of the shift, same parameters, but the renal profiles can be decreased to q4,” M’Benga said as he jotted the orders down.  “Keep the fluids where they are and let me know when the output comes back up to normal.”

 

Christine nodded, adding the changes to her mental list.  “What else?” she moved on.

 

M’Benga glanced at the PADD, then back to the monitors and drips.  “Cardiac,” he started, “…..you can decrease the rinhepin to 300 units an hour, but keep the continuous perfusion scans, please.  The demcorzen can stay where it is.  I’m still hoping he’ll convert chemically.  If he still hasn’t in the next twenty-four hours, we may have to discuss cardioversion.  Blood pressure is holding at the low end of normal, but I’m happy with that right now.  Standing orders for fluids and pressors remain.”  He moved to the ventilator and pulled up the record.  “Respiratory…..” he continued, “….I know he hasn’t attempted any breaths on his own, but I’m going to drop him to SIMV, same rate, volume and oxygen percentage.  I want to see if he’ll try.”

 

Christine nodded, flagging the orders on her screen and making audio-prompt notes for herself.  “Neurological?” she ventured.

 

M’Benga sighed, double-checking McCoy’s pupil response.  “He’s still extremely sluggish,” he pointed out, knowing that Christine already knew that from her own assessment.  “I just turned off the sedation briefly….” he paused at Christine’s shocked expression.  “I know,” he soothed, trying to keep the tinge of exasperation from showing, “but the Captain didn’t miss anything.  It was highly unlikely that Leonard would wake up now, especially with the renal complication.  Pupils are still sluggish, there was no response to voice command and he just _barely_ responded to painful stimuli.”  He sighed heavily.  “I’ll inform the Captain,” he assured Christine, noting her relief that she wouldn’t have broken the Captain’s trust in her.  “We can do a proper sedation vacation later this evening.  Hopefully, his renal condition will continue to improve during the day, giving him some strength.”

 

Christine pulled her professional mask back on, pushing aside the split-second of rage that had flooded her chest when M’Benga said that he had turned off the sedation without the Captain there.  “When do you want testing done?” she asked.

 

M’Benga thought for a moment, reviewing his new orders.  “I think we’ll keep the EEG at tomorrow morning as planned,” M’Benga said.  At Christine’s raised eyebrows, presumably due to his less-than-promising neurological assessment, M’Benga hastily added, “for _now_.”  His voice softened.  “We can always change things, Chris.  We’ll see how he does today.”

 

Christine deflated.  “Of course.  I’m sorry, Doctor,” she said, pulling herself straight again, channeling her energy into her next task.

 

“I believe Leonard would say, ‘don’t worry about it,’” M’Benga smiled gently.  He headed for the door.  “You know where to find me if you need me.”

 

Christine nodded appreciatively and headed for the IV drips.  As she decreased the rinhepin and double-checked the new ventilator settings, she whispered to McCoy, “well, he was _close_.”  She knew that Leonard would have at least added her nickname to the acknowledgement, if not one of his drawled out, Southern affections, complete with a soft version of that radiant smile.  “Don’ you worreh bah’tit dahlin’,” she remembered him assuring her one evening, fatigue making his normally soft accent thick as a humid Georgia night.  Damned if she didn’t _miss_ that.

 

Christine grabbed the skin sealant.  “I’m not so happy about that ‘barely responsive to painful stimuli’ business,” she warned McCoy as she worked.  “Something good’s going to happen today – don’t prove my gut wrong.”

 

She was just finishing the skin sealant and debating whether to give the next tri-ox treatment a little early, when the comm buzzed. 

 

Scotty’s Scottish burr greeted her.  “Mornin’, Nurse Chapel,” he said.  “I was wonderin’ if I couldn’t visit with the Doctor for a wee bit.”

 

Christine smiled.  “Perfect timing, Mr. Scott.  Come on in,” she said, untinting the windows.

 

Scotty entered the room, nervous eyes taking in the scene.  “I cannae stay for long,” he apologized.  “The lads in Engineering need _someone_ ta’ watch what they’re doin’,” he grinned good-naturedly.

 

Christine laughed.  “Stay as long as you want, Mr. Scott,” she said.  “I’ll be back in a few minutes for his next treatment.”

 

Scotty nodded his thanks, pulled the chair to McCoy’s side and started talking.

 

Christine took a moment to sit at the desk, checking her charting and next treatments, reveling in the chance to get off her feet.  Ten minutes later, she coaxed herself back up, pausing at the ICU windows before heading to the medication cabinet.  Scotty was talking animatedly about something, eyes bright.  Christine figured it had to do with the Enterprise.  If anyone could be more in love with the ship than Captain Kirk, it was Scotty.  She smiled, watching Scotty’s hands illustrate his point.  For all McCoy’s claims that he was a simple country doctor, the man was more than capable of brilliance beyond medicine.  Christine had listened to Leonard and Scotty talk before, and McCoy managed a fair grasp of the basics of starship engineering, based on his medical background in physics.  Scotty was an excellent teacher, patiently explaining new concepts to Leonard when his eyes would glaze over until both men were bundles of excited enthusiasm: Scotty for the love of his ship and craft, Leonard for the joy of learning something new.  The two men were surprisingly similar – they were both “fixers”, one of organic material, the other inorganic, but both equally passionate about their calling.

 

Scotty looked up as Christine walked into ICU, a tri-ox syringe dangling from her right hand.  “Well, Doctor,” he said, standing up and stretching, “I suppose I ought ta’ get back ta’ Engineering.”  He laid a hand on McCoy’s shoulder briefly before walking to Christine.  “Would it be all right if I gave the lads an update on Dr. McCoy?” he asked seriously.

 

Christine smiled.  Bless Mr. Scott and his concern for patient confidentiality.  “Of course,” she gave him permission.

 

“Thank ye lass,” Scotty smiled softly, patting Christine’s arm before heading back to Engineering.

 

****

 

The next several hours passed quickly, with medications, treatments, and more research.  Christine was grabbing a quick lunch at her desk when the comm buzzed.  She swallowed quickly and hit the switch.  “Chapel here,” she acknowledged.

 

“Hiya sugar,” Uhura’s lyrical voice greeted her.

 

Christine couldn’t help but smile – Uhura just had a way of relaxing everyone she came in contact with.  “Hi yourself,” Christine grinned.  “You on break?” she asked.

 

“I’m off,” Uhura smiled.  “I was only covering half a shift for Robertson this morning.  Are you and Dr. McCoy up for a little company?”

 

Christine waved her fork at the screen in a ‘come on down’ gesture. 

 

Uhura nodded.  “I’ll be right down,” she promised, ending the transmission.

 

****

 

Christine was walking out of M’Benga’s office, still grinning, when Uhura entered sickbay.  McCoy’s urinary output was finally back to the minimum 30 ccs an hour and his last renal profile showed continuing improvement.  “Go on in, Nyota,” Christine motioned toward ICU.  “I just need to call the Captain and give him some good news for a change.”

 

Five minutes and a much happier James T. Kirk later, Christine walked into ICU, where Uhura was perched on the side of the bed, holding McCoy’s right hand and filling him in on the ship’s gossip.  She looked up as Christine came in with an armful of IV tubing and several medications.  “So, what was the good news?” Uhura asked breathlessly.

 

Christine filled Uhura in on the renal issue as she took down the dwindling demcorzen, rinhepin and virdipan drips and replaced them with new bags and tubing.  The two women talked for a few minutes, giving and taking in the easy manner of good friends, until M’Benga poked his head into the room and asked Christine to give him and Jack a hand with another patient.

 

Christine nodded toward McCoy with a smile.  “I’m sure he’s waiting to hear the rest,” she grinned.  Uhura always knew what was going on around the ship, and McCoy often confirmed his suspicions with the communications officer before going after Kirk or Spock for doing something stupid.

 

****

 

By the time “just a little bleeding” had become a full-blown GI bleed and Christine helped M’Benga and Jack rush Yeoman Moreno into surgery, almost an hour and a half had passed since she left Uhura in ICU.  She stopped by her desk, grabbing the PADD and checking which medications were due.  Gathering the tri-ox and another dose of anti-ileus meds, Christine headed for the doors. 

 

Uhura was still perched on the side of the bed, but her hand had moved to cup McCoy’s cheek as she sang softly, eyes bright in her expressive, compassionate face.  She stopped briefly, humming as she met Christine’s eyes.  Christine waved her back to her singing and gathered the bandage supplies for the shunt.  Uhura had been the first crewmember McCoy drafted once he decided to launch a music therapy pilot for sickbay and she was the one he frequently called to soothe an anxious patient or act as an adjuvant to pain management.  It was fitting that she was there with him now.

 

Christine allowed herself to relax to Uhura’s voice as she administered the tri-ox.  She soon found herself humming along to the familiar melody, trying to place the name of the song.  It was so familiar……it almost reminded her of the old song “Georgia On My Mind”, but the words were all wrong.  She rewrapped the shunt site and tried to focus on the lyrics. 

 

“…..mens mea…..” Uhura continued softly.

 

Christine latched onto those words as she cleaned up her supplies and grabbed the next hypo.  “Mens” kind of reminded her of “mental” or “mind”……Christine’s brain suddenly kicked in and she realized why it was so familiar – nursing school.  Anatomy and physiology.  She turned to Uhura.  “Is that _Latin_?” she asked, amazed.

 

Uhura nodded, finishing the lyric before stopping, her thumb continuing to lightly stroke Leonard’s cheek. 

 

Christine let out a surprised breath.  “Well, the song is perfect,” she said - she had always loved that song and its connection to her CMO, “but Latin?  I didn’t think anyone translated _anything_ into Latin anymore.”

 

Uhura shrugged, smiling shyly. 

 

Christine suddenly understood.  “ _You_ translated it, didn’t you?” she asked the linguist.  Uhura nodded.  Christine could already feel her heart swell with anticipation at Uhura’s explanation.  “Why Latin?” she asked, almost breathless with curiosity.

 

Uhura thought for a moment, her eyes never leaving Leonard’s face.  “It just felt right,” she began.  “The Romans were people of the earth,” Uhura explained.  “They were farmers whose happiness came from the land.  Did you know that the great name ‘Cicero’ actually means ‘chickpea?’” Uhura laughed softly at Christine’s surprised chuckle.  “I know it’s a dead language, but a language is never really dead so long as _someone_ breathes life into its sounds…….and it just _felt right_ ,” Uhura finished, her quiet voice strong in its conviction.

 

 _“People of the earth,”_ Christine thought to herself, watching Uhura stroke Leonard’s face,  _“…..and the old country doctor.”_   She shook her head in amazement.  Only the musician, linguist, and sensitive, perceptive heart of Nyota Uhura would have been able to honor Leonard McCoy’s down-to-earth soul with a three hundred year old song in a thousands year old dead language, while making his head nurse tear up.

 

Christine was still trying to put her feelings into words when the monitor beeped. 

 

Uhura’s head snapped up.  “What’s wrong?” she asked nervously.

 

Christine rushed to the monitor, heart pounding with a sudden surge of adrenaline, preparing for the next crisis.  Her eyes widened at the green box winking at her from the cardiac scan.  Tentatively, she pulled up the message, read it twice, then pulled up an EKG strip covering the last minute.  “Oh my God,” she whispered.

 

“Chris?” Uhura asked again, dark eyes begging for answers.

 

“He converted,” Chris finally managed to get out.  She drew in a breath, letting it out in shaking amazement.  She couldn’t believe it.  It really _did_ work.  She finally pulled herself together and met Uhura’s eyes.  “He’s out of a-fib,” she explained, “the potentially dangerous heart rhythm he’s been in since we resuscitated him.  He’s in a perfect regular sinus rhythm.”

 

Uhura’s face blossomed into a wide smile.  She looked back down at McCoy, her eyes bright.  “We all knew your heart was strong,” she said softly.

 

Christine didn’t know whether to laugh or cry.  Or both.  She called M’Benga on the comm, then turned back to Uhura.  The scientific part of her brain told her that it was only a matter of time – that M’Benga was probably right, that McCoy’s improving renal function and the healing time since the cardiac regen and reperfusion had finally strengthened his heart enough to accept the demcorzen and break the rhythm.  Her heart, however, was insisting that the woman still humming in front of her had finally pushed Leonard over the edge toward progress.  “Thank you,” she said sincerely, taking Uhura’s hands in her own.

 

Uhura gave her a confused look.  “For what, sugar?” she asked.

 

“For this,” Christine pointed to the regular rhythm on the EKG.

 

“That wasn’t me,” Uhura insisted, bringing both their gazes back to McCoy’s still face.

 

“You helped,” Christine insisted right back, holding up a hand to silence her friend before she could protest.  “You _did_.  Now shut up,” she laughed.

 

****

 

The rest of Christine’s shift passed in a blur of assessments, meds, new orders, and a quick visit by a very hopeful Captain Kirk.  M’Benga had decided to go ahead with the planned sedation vacation that evening, encouraged by McCoy’s improving renal function and steady sinus rhythm.  Christine was practically bouncing as she administered the last tri-ox treatment of her shift and prepared for Kirk, Spock, and M’Benga to join her in ICU.  _“Come on, Leonard,”_ she urged him silently, _“keep making today a good one.”_

 

Ten minutes later, M’Benga walked in, scanner in hand.  He was completing his baseline assessment when Kirk rushed in, followed calmly by Mr. Spock. 

 

“We haven’t started yet, Captain,” Christine assured the flustered man. 

 

Relief flooded Kirk’s face.  He pulled himself straighter, drew in a few deep breaths, and moved to McCoy’s side, Spock right behind him.

 

M’Benga handed the scanner to Christine, who reviewed the data quickly and nodded in agreement.  Christine moved to Kirk’s left, standing next to the IV pump, while M’Benga took a place on McCoy’s left side. 

 

“Christine is going to turn off the sedating medication,” M’Benga explained.  “It will leave his system very quickly.  We will be watching for changes in his vital signs that may indicate he is ready to wake up.  If he _does_ wake up, it will likely be for a short time only.”  M’Benga paused, making sure he had Kirk’s and Spock’s full attention.  “I can not guarantee he is ready to wake up, or that he will wake up at all,” M’Benga said seriously.  “I don’t wish to alarm you, but we still do not know how well the treatment has worked, if at all.”

 

Kirk nodded tersely.  “I understand,” he said, moving forward and taking McCoy’s hand.  “Do it.”

 

Spock nodded his understanding and also stepped forward, his right shoulder brushing Kirk’s, his hand gently resting on McCoy’s shoulder.

 

M’Benga looked at Christine and nodded.  She turned off the drip.

 

Thirty seconds passed with no response.  Kirk looked up at Christine.

 

“Talk to him, Captain,” she reminded him, meeting M’Benga’s eyes over the bed.  “Give him something to focus on.”

 

Kirk opened his mouth to speak, but was cut off by the screaming of a ventilator alarm.  Wild eyes sought explanation as Christine rushed to the machine.

 

“What reading?” M’Benga asked calmly, watching the monitors over the biobed.

 

“High pressure,” Christine confirmed with a relieved smile, “and he just went to 14/12.”

 

Kirk toned down his glare at the last minute.  “What’s going on?” he demanded.  Since when were sickbay alarms something to smile about?

 

“He’s fighting the ventilator,” Christine said.

 

Spock raised an eyebrow, half-turning to face Christine.  Apparently he felt the same way Kirk did.  “Nurse Chapel, I do not understand how fighting the machine breathing for him could in any way be beneficial for the Doctor,” he stated dryly.

 

Christine looked down, her smile widening as McCoy’s eyes started to flutter under closed lids.  “Leonard breathed out when the machine breathed in.  He took a breath on his own.  More than one, actually,” she clarified, checking the monitor.  She drew their attention back to McCoy’s face.  “He’s trying to wake up.  Talk to him,” she urged.  As much as she wanted to get closer, she forced herself to step back.  Kirk and Spock needed this.

 

“Bones?” Kirk asked quietly, almost reverently.

 

Spock’s grip on McCoy’s shoulder tightened almost imperceptibly.  “Dr. McCoy, you may open your eyes now,” he offered, brown eyes barely hiding his hope.

 

“Come on, Bones!” Kirk almost shouted, leaning into McCoy’s line of vision.  He moved both hands to the sides of his friend’s face.  “Open your eyes,” he pleaded.

 

Spock closed his eyes, reaching silently for McCoy’s mind, brushing lightly against his friend’s essence, offering strength.  His eyes snapped open and he almost stepped back in shock.  He looked over at Kirk, only to find that the Captain had stepped forward.

 

Hazel met blue.                

**Notes for the Chapter:**

> Medical/Various Notes:
> 
> \- UO stands for “urinary output.” Generally, healthy kidneys produce an average of at least thirty ccs an hour.  
> \- Potassium is an electrolyte tied very closely to cardiac function. Patients in renal failure tend to have many electrolyte imbalances, usually increased amounts, because their kidneys can’t process and get rid of the excess. Too much potassium can lead to dangerous heart rhythms or cardiac arrest. A “binder” refers to a medication that binds to an electrolyte (or other substance in the body) and helps the body get rid of it.  
> \- When Christine is disinfecting the central line lumen and drawing blood, she is saving McCoy from another needle stick by drawing blood from the IV. It’s a nice way to save a patient’s veins, especially if they need frequent blood work.  
> \- From the last chapter: GFR stands for “glomerular filtration rate.” This is a lab value used to determine a patient’s level of kidney failure – in those cases, this number goes down. BUN and creatinine are two blood values used to determine how well the kidneys are functioning – in cases of kidney failure, these numbers both go up.  
> \- PVC stands for “premature ventricular contraction.” It is an extra heartbeat produced by an irritated area in the heart. Multifocal PVCs have different forms on the EKG and shows that they are coming from a variety of areas in the heart, which is worse than if they were just coming from one location. “Bigeminal” refers to a PVC every other beat in an EKG while “trigeminal” refers to a PVC every third beat. A “run” is several PVCs in a row. Any of these can lead to a potentially lethal heart rhythm.  
> \- SIMV stands for “synchronized intermittent mandatory ventilation.” With this ventilator setting, the machine will give the patient the prescribed number of breaths per minute, along with the set amount of air and percentage of oxygen desired, however, if the patient attempts to take a breath on their own, the machine will back off and allow the patient to take in their own volume of air. This helps the medical staff determine how effectively someone may be breathing on their own and whether it may be time to start weaning them off the machine.  
> \- A “GI bleed” is a gastrointestinal bleed. These often start as a small amount of blood from the rectum before the internal mess explodes outwardly. Literally.  
> \- Uhura and Ray Charles’ “Georgia On My Mind.” Another one of those “pops into your head in the shower” things. Please excuse the Latin – I was going to translate the whole song, but then decided to just put a snippet in here, so I didn’t conjugate it based on its place in the lyrics. What Uhura says about the Romans is true and “Cicero” really does mean “chickpea.” I have to thank my awesome university Latin professor for that one.  
> \- McCoy’s heart going back into a normal rhythm after Uhura’s singing is based on my own experience doing music therapy sessions in nursing school. I saw a whole room of psychiatric patients relax to the sound of the pan flute. A severely depressed woman who never spoke in groups actually engaged me in conversation, holding the instrument and asking how it was played. Pretty cool.  
> \- “14/12” on the ventilator reading means that while the machine is programmed to deliver 12 breaths per minute, the patient is actually taking 14 breaths per minute, indicating that they took two breaths on their own.


	7. Chapter 7

**Summary for the Chapter:**

> McCoy is critically injured and Christine Chapel does what she does best. A character study of Leonard McCoy and a look into the world of the Enterprise medical team.

 

 

“Bones?” Kirk asked, his voice wavering with relief.  He gently patted his friend’s face.  “Bones, look at me.”

 

Christine watched M’Benga move closer, penlight in hand, as Kirk looked for a response from his friend.  She sighed softly.  Although the Enterprise had lost her fair share of crewmembers, James Kirk still had something of an almost naïve belief in medicine.  Even in situations where it was clear that there was absolutely nothing modern medicine could have done, Kirk would still look to the sickbay staff, to _McCoy_ , and in a heartbreaking combination of furious Captain and disbelieving child, wonder why they hadn’t been able to save the day.  Christine had shared a post-shift drink with Leonard on more than one of those occasions, her own heart breaking as he was crushed by the full weight of Kirk’s faith in him, both as healer and friend.  Yet, Leonard constantly proved that faith warranted and Christine had been witness to some of the most inspired moments in medicine working with him.  The Enterprise medical staff had a reputation for not only cheating death, but, as Mara put it, “kicking its ass.”  A large part of that had to do with Leonard McCoy’s passionate genius and James T. Kirk’s equally passionate, unshakable trust in his CMO. 

 

_“But,”_ Christine murmured to herself, _“we can’t always win….and sometimes death isn’t the enemy…..”_   She shook her head.  Where had _that_ come from? 

 

“Bones?” Kirk’s voice had changed.  Christine swore she heard a touch of fear. 

 

_That_ got her attention. 

 

Christine’s mind began racing as her eyes swept the room, gut churning.  M’Benga was frowning, leaning over McCoy’s face, issuing slow, simple commands, the penlight discarded, his hands squeezing Leonard’s.  Kirk had pulled back from McCoy’s face, letting M’Benga work, his shoulders tense, jaw clenched, but one hand still gripping McCoy’s forearm desperately while Spock……

 

Christine swallowed against sudden, inexplicable nausea.  Spock was still standing in the same place he had ended up after his apparent attempt to reach McCoy’s mind.  Christine replayed the scene  – Spock had stepped _back_ and his expression….well, there was no other word for it – it was shock, plain and simple.  While Kirk had moved forward, Spock had stayed a full step back from the biobed, the hand that had been on McCoy’s shoulder in support now hanging limply at his side.  _“What did he see?”_ Christine worried silently, just before her gut kicked in full force and she found herself swallowing hard against the sudden surge of bile in her throat. _“It wasn’t what he saw,” _the realization slammed home.  _“It was what he didn’t see.”_  

 

She was already in motion when M’Benga’s eyes met hers.  Christine was at his side in seconds, grabbing a scanner from the supply table and passing it to him in the controlled rush of starship medical staff.  Her mind reeled as M’Benga ran the scanner over McCoy – one glance at the penlight lying discarded on the bed showed that McCoy’s pupils had reacted normally to light, but Kirk’s voice and M’Benga’s eyes confirmed that there had been no response to verbal command.  Christine moved toward the overhead scanner, setting up the scan parameters for the orders she knew were coming.  With her finger poised over the start button, her gut screaming, she still felt compelled to look…..as if only Leonard’s face would tell her the _real_ truth.

 

Christine had always loved Leonard’s eyes.  They were a very close second to his smile.  She had seen those blue mirrors reflect just about every emotion a human could have - blazing with anger at unnecessary death, hardening with worry as the next mission was declared, softening with compassion as he comforted a post-operative patient, shining with impish delight as he engaged Spock in yet another battle, positively glowing as he pulled another breakthrough out of his head and put it into practice.  They were never just “blue” – McCoy’s eyes were a wordless biography, a guide to his very nature.

 

Christine slowly looked down.  The clinician in her immediately noted the normal pupil size, the unfocused gaze, the disappearing irises as the eyes slowly rolled back.  The _nurse_ noted the blue.  It was as if the entire story had been erased.  They were just a color, a word – just “blue.” 

 

Oh, God.

 

M’Benga’s soft lilt was almost jarring in its sheer emotion.  “Christine, please prepare for an EEG.”

 

“Already prepared,” she managed.  At M’Benga’s nod, she started the test.

 

Kirk looked absolutely devastated.  “It didn’t work?” he whispered, disbelief flooding his voice.  “But…..he woke up.” 

 

Christine swallowed hard, flicking her eyes back to the monitor.  How she wished they could be the miracle workers he desperately wanted them to be.

 

M’Benga drew in a breath, pulling his attention from the scan and forcing himself to meet Kirk’s eyes.  “I don’t know,” he began wearily.  “We are going to do some tests to examine Leonard’s brain function.  It is possible that some areas were improved, while others were not.”

 

Kirk sank into the bedside chair as the doors hissed open and Mara stepped in.

 

Christine glanced at the chronometer.  She hadn’t even realized it was shift change.

 

Mara’s eyes swept the room, quickly putting the overall feeling of despair together with McCoy’s open eyes and the EEG running on the monitor.  Stifling the memories of Omega II, she pulled herself straighter and walked to Christine’s side, laying a gentle hand on her arm in support, waiting for the next step.

 

Mara’s action seemed to finally pull Spock from his shock and he stepped forward as well, taking his place at Kirk’s side, sleeve lightly brushing the Captain’s shoulder, ready for whatever came next.

 

The scanner beeped and Christine touched the screen lightly, pulling up the results.  Mara shifted as M’Benga moved closer, three sets of eyes scrolling down the data.  Christine was no neurologist, but she knew the waves were too slow and that there shouldn’t be any delta or theta waves present.  As M’Benga turned away, she returned Mara’s supportive squeeze and pulled up the cranial scan menu.

 

M’Benga waved Kirk back down as the Captain stood up for the news, but Kirk remained standing, moving closer to the bed.  Spock followed, but remained a half-step behind and to Kirk’s left.  Christine immediately recognized the position as the one the nurses used to support an unsteady patient.  Of course, Spock wouldn’t be preparing to catch the Captain.  She glanced at Mara and saw the same question in her eyes.

 

M’Benga sighed.  “The EEG shows that there is brain function, but the regular brain waves are very slow and there are two types of waves present that are not usually seen in a healthy adult brain.  This, combined with the fact that Leonard did indeed open his eyes, show a normal pupil response, and initiate breaths on his own, suggests that at least some of the part of his brain that perform basic life functions is functioning normally.  His lack of response to vocal commands suggests that other areas of higher functioning are still damaged.”  He looked to Christine, who already had the next scan prepped and nodded his permission to begin.  Turning back to Kirk, he said, “we are going to do a full cranial scan, which will tell us exactly which parts of the brain are functioning and at what capacity.  It will also detail any damaged areas.”

 

Kirk nodded silently, taking hold of McCoy’s arm again, as if he could will all his hope into the scan results by touch alone.

 

The monitor beeped and the screen was flooded with images and interpretations.  Christine moved the results to the PADD in Mara’s hand and grabbed the one from the supply table for M’Benga.  She read over Mara’s shoulder, taking in the cold, clear data of healthy versus infarcted tissue, of current functional ability and treatment recommendations.  She pushed back tears at the first and most practical recommendation, according to the computer’s analysis.

 

Before M’Benga could open his mouth, Spock had moved slightly closer to Kirk’s side, standing shoulder to shoulder with his friend, one hand lightly resting on McCoy’s chest.  M’Benga sighed heavily.  “There has been some progress,” he began, knowing it wasn’t going to be enough to outweigh the rest of the results.  “The treatment worked well on Leonard’s brain stem, allowing him to regain several basic functions vital to life.  I would expect that he would continue to improve in the next twenty-four hours, eventually being able to breathe on his own and reliably regulate his own vital signs.”

 

Mara shuddered at the memories of dead miners staring at her through breathing bodies.  Christine leaned gently into her friend for support.

 

M’Benga glanced down at the PADD again as Kirk braced himself for the inevitable.  “However, there is still a significant amount of infarcted tissue in the frontal and parietal lobes.  These control functions such as reasoning, problem solving, emotion, recognition, and movement.  So while he has gained some basic reflexes, such as pupil and pain response,” M’Benga pinched McCoy’s foot, showing the slow jerk of the limb away from the painful stimuli, “they are basically reflexive, instinctual responses.  There is no real thought behind them.”

 

Kirk closed his eyes.  “So, what you’re saying, is that everything that makes Bones… _Bones_ …..is gone.”

 

Christine knew the answer as soon as she saw the scan results, but the words _still_ hurt.  “Those areas of his brain are largely dead,” M’Benga confirmed.

 

Kirk hitched in a breath, tightening his grip on McCoy.  Spock’s eyes were practically radiating sorrow as he moved his free hand to Kirk’s arm.  M’Benga dropped the PADD on the table, shoulders slumped in defeat.  Mara had one hand fisted against her mouth, shaking her head as if she couldn’t believe that it hadn’t worked.  _“This is the Enterprise,” _her eyes were saying.   _“It should have worked.”_

 

Christine had to turn away from the blinking scan results, several emotions warring for control.  She blinked back the shocked tears, the anticipatory grief at losing her friend.  She struggled with the naïve shock in Mara’s eyes, wondering where they had gone wrong, ignoring the clinical part of her mind which pointed out that it had been a long shot from the beginning.  Mostly though, she found herself fighting the childish urge to stamp her feet and shout that it wasn’t fair.  Leonard had survived a six minute resuscitation, major regenerative surgery, dysrhythmias, hypotensive episodes, renal failure and almost forty-eight hours of experimental treatment……for what?  To come out with the ability to keep a body going for what was essentially a dead brain?  He was a good man.  The best.  He had just been standing there, keeping himself upright in a ship determined to dump him on his backside.  They all did that - everyday.  Why _that_ panel?  Why _him_? 

 

Kirk’s eyes were bright with unshed tears.       

 

“Dammit, Leonard, you’re making the Captain cry,” she whispered, choking on the words as she realized he’d never respond.

 

It just wasn’t fair.

 

Kirk was the first to regain his voice.  “What do we do now?” he finally managed.

 

M’Benga swallowed.  “You know as well as I do Captain, that Leonard does not wish to be kept alive artificially without hope of improvement and although this is not technically complete brain death, it is close enough in his terms.  We have to let him go.”

 

_“Let him go,”_ Christine thought quietly.  It sounded so much better than the computer’s unfeeling recommendation of “termination.”

 

“I know,” Kirk nearly sobbed.  He drew in a shuddering breath, leaning into Spock’s supportive grasp and pulled himself straighter.  “But I’m his proxy…..I have to make the decision.”

 

Christine didn’t envy him that position.  Every crewmember aboard the Enterprise had a medical proxy, someone in charge of making decisions for them if they became incapacitated.  Most chose a family member, but Leonard, already in the unenviable position of being the Captain’s close friend, physician, and proxy all at once, had asked Kirk. 

 

“I don’t want Johanna to have to be makin’ those kinds of decisions,” McCoy had pleaded.  “Please, Jim.”

 

Kirk had agreed, and anytime either of them had acted as proxy, it had just been for a short time – a decision or two in treatment options that, for the most part, were all leading to recovery to begin with.  This was the decision to terminate life support – something Kirk wasn’t ever going to be ready for.

 

“What would we do?” Kirk asked, trying to prepare himself for the procedure.

 

“We would stop all medications except for sedation, remove all other treatments, and turn off the ventilator,” M’Benga explained.

 

Kirk’s brow furrowed.  “But if he’s starting to breathe on his own, he might be able to breathe off the machine,” he looked to M’Benga for confirmation.

 

M’Benga nodded.  “You’re correct,” he acknowledged.  “In that case, we would add another medication to the sedation.  An overdose of a narcotic would slow his breathing until it stopped.  Between the sedation and the narcotic, he wouldn’t feel anything.  It’s very peaceful.”

 

“But I still have to authorize a medication that will kill Bones,” Kirk said softly.  “I know it’s the right thing to do, what he wants….but…..” he swallowed hard, looking back down at McCoy’s face.  He looked back up.  “Has Johanna been notified?” he asked.

 

M’Benga looked to Christine.  “Not yet, Captain,” she said quietly.  “We were going to contact her in the morning after the EEG results.”

 

“I think she should know,” Kirk said, focusing on McCoy’s hands.  “I don’t feel right making the decision without her at least knowing what’s going on.”

 

M’Benga nodded and motioned to Mara to restart the sedation.

 

“Would you like us to contact her, sir?” Christine asked gently.

 

“No, I’ll do it,” Kirk said, letting out a breath as he pulled himself together.  “Is it all right if I use the comm in the office?” he asked.  He couldn’t bring himself to call it Bones’ office.

 

“Of course,” Christine said.  Before she could offer to walk him there, Kirk was already gone.

 

Spock pulled the chair closer and sat down, eyes closed, one hand still resting on McCoy’s chest.  M’Benga nodded wearily to Mara and Christine and left the room.  Christine reset the monitors, filing the scan results, and filled Mara in on how an incredibly promising day had gone straight to hell.

 

****

 

Jim Kirk slumped into McCoy’s chair and leaned forward, head in his hands.  Sighing heavily, he scrubbed his hands across his face, through his hair, and forced himself to sit up straight.  He hit the comm switch.  “Kirk to Communications.”

 

“Communications, Uhura here,” came the response.

 

Kirk started.  Uhura wasn’t supposed to be on shift.  She had covered a few hours of Robertson’s that morning and wasn’t due again until the next day.  Curiosity got the better of him.  “Aren’t you supposed to be off, Lieutenant?” he asked.

 

“I’m not really here, sir,” Uhura smiled.  “Mr. Slate is on tonight, but he was going to leave during the first message with his wife and newborn daughter to come on shift.  I told him not to report until he’d at least seen the child.”

 

Kirk couldn’t help but smile.  Uhura was an excellent department head.  “Well done, Uhura,” he smiled softly, before the cloud passed back over his features.  One daughter was seeing her father for the first time while he had to inform another that she’d never see hers again.  He swallowed hard.  “Can you please contact Johanna McCoy, highest priority?” he asked.

 

Uhura’s eyes widened as she stifled back a gasp.  “Is Dr. McCoy…..?”

 

“Not yet,” Kirk said simply.

 

Uhura wiped her eyes.  “I’ll put it through as soon as I have her, sir,” she said.

 

“Thank you,” Kirk said quietly as the screen went blank.

 

Kirk stared at the screen and tried not to think of what he was going to say.  This certainly wasn’t the first time he had delivered bad news to a crewmember’s loved ones, but damned if it never got any easier.  Bones had always told him that it was that fact that made him a good man – that if he ever found it easy, he would have lost his humanity. 

 

He sighed again, trying to picture Johanna.  He had never met Bones’ daughter and while the pride radiated off him in waves when he _did_ talk about her, McCoy was generally very quiet about his home life.  It took the aftermath of a horrific mission that he never wanted to remember and enough alcohol to border on stupidity before Kirk had coaxed the story of Jocelyn and the divorce from McCoy one night and even through the haze of the alcohol, Kirk understood enough to never bring it up again.  He had extended that to Johanna as well, letting McCoy be the one to bring her up in conversation, even though he desperately wanted to know more about that part of his friend’s life.  He had never seen more than the holo of a seven year old Johanna in McCoy’s office until he had inadvertently walked in on Bones while he was on a call with her a few months ago. 

 

Kirk smiled at the memory.  As CMO, McCoy pretty much had an open door policy.  Even when he was off-duty, he never turned anyone away, whether it was an anxious crewmember in need of his psychiatric training or an insomniac starship Captain looking for someone to have a drink with.  It was the latter that pressed the buzzer to McCoy’s quarters that night, sauntering in at the welcoming, “come on in.”

 

Kirk had paused in the doorway as he heard McCoy continue talking.  Confused, he wandered a little further in and saw McCoy standing up from the comm, smoothing out his black t-shirt.  The physician looked up and grinned as he met Kirk’s eyes.

 

“Hiya, Jim,” McCoy drawled amiably.  “Somethin’ I can do for you?”

 

Kirk frowned at the glow still present on the comm screen.  “Are you in the middle of something, Bones?” he asked.  “I can come back.”

 

“Nonsense,” McCoy insisted.  “she’s used to me havin’ to run off to some crisis or other on this damn ship.  What’s goin’ on?”

 

Kirk kept his surprise in check.  He rubbed the back of his neck, embarrassed.  “Couldn’t sleep,” he muttered.

 

McCoy smiled knowingly.  “I was just about to fix a drink for myself,” he said, gesturing Kirk to the couch.  “Have a seat.”

 

Kirk sank into the couch as McCoy walked back over to the comm.  “Sorry, darlin’,” he said with a smile, “but it looks like we’ll have to pick up again next time.  I’ve got a Captain that needs medicatin’,” he winked.

 

Kirk heard the responding laugh and craned his head, trying to catch a glimpse of the screen. 

 

“Captain Kirk’s there?  Could I meet him real quick, Daddy?  It’d be nice to have a face for all your stories.”

 

“Well…..” McCoy hedged, glancing over and seeing Kirk’s nosiness.

 

“Is that Johanna?” Kirk asked, realizing he was caught.

 

“Yes, Jim,” McCoy sighed good-naturedly.  He turned back to Johanna.  “I suppose it’ll keep him outta trouble while I get the glasses poured.”  He motioned Jim over.  “James T. Kirk, Johanna McCoy,” he introduced the two.

 

“It’s a pleasure,” Kirk smiled, bowing slightly.

 

McCoy rolled his eyes.  “Behave yourself,” he growled.

 

“Daddy!” Johanna laughed, indignant. 

 

“I was talking to the Captain,” McCoy clarified, the glare softened by the grin in his eyes. 

 

Kirk had spent the next half hour getting to know Johanna, sipping bourbon while McCoy sat nearby, supervising.  It seemed that the only thing Johanna had inherited from her mother was a few streaks of red hair.  She had inherited her father’s blue eyes and expressive face, along with a distinctly thicker Georgian accent, the kind he only heard from Bones when he was exhausted or sick.  Her personality was all Bones – by turns Southern charm, brilliant perception and fierce passion.  She had inherited her father’s love of medicine and was studying nursing at a Georgia university, but unlike her father’s distrust of much of modern technology, Johanna was fascinated with machinery, focusing on nursing research, with a particular interest in bioengineering.  She wanted to help create the technology that people like her father needed at the bedside, while simultaneously having the knowledge of the direct caregiver’s role. 

 

Kirk could have talked to her for hours, but Bones finally got up, pointing out the time back on Earth.  “Besides, gotta stop you before you get _too_ charming,” he muttered.

 

“What do you mean?  I’m always charming,” Kirk had teased.

 

McCoy snorted.  “Like hell you are.”

 

Kirk said his goodbyes and stepped away to allow Bones some privacy.  He had simply sat down with a smile and told her to sleep well.  “Bye, sweetheart,” he said softly.

 

“Bye, Daddy,” Johanna replied.  “Love you.”

 

“Love you too, darlin’,” McCoy whispered, ending the call.      

 

****

 

Kirk was startled back to the present as the comm buzzed.  “Captain, I have Johanna McCoy,” Uhura said.

 

Kirk cleared his throat.  “Put her through, Lieutenant.”

 

“Yes, sir.”

 

Kirk took a deep breath as the screen came to life and Bones’ vibrant blue eyes looked back at him.  He must not have hidden his thoughts as well as he had hoped, because Johanna’s sharp gaze took in his face, put it together with the priority coding, and immediately demanded, “What happened?”

 

Kirk sighed.  “There was an accident.  Your father was seriously injured,” he finally managed to say.

 

Johanna’s eyes widened.  “What happened?” she asked again, softly.

 

Kirk explained everything he could, from the initial resuscitation and subsequent surgery, to the post-operative treatment and complications, ending with the EEG and cranial scan results and the recommendation at hand. 

 

Johanna needed nearly thirty seconds before she was finally able to pull her hand away from her mouth and trust her voice.  “Where are you?” she asked.  Realizing she should probably clarify that statement, she tried again.  “Where is the Enterprise located right now?”

 

Kirk frowned, then realized her meaning.  “Not close enough.  We’re a full three days from Earth, even at maximum warp.”

 

Johanna swore, burying her face in her hands.  “I’m sorry, Captain,” she apologized.  “It’s just….I should be there.”

 

“I know,” Kirk said softly.

 

Johanna sucked in a shaky breath.  “Dr. Kerebus’ article was promising,” she mused out loud, the scientist suddenly taking over in an achingly familiar manner.  “Daddy and I….” her breath hitched before her professionalism took hold again.  “We discussed a few possibilities.”  She looked back up at Kirk.  “I know what he wants,” she suddenly said, renewed focus in her eyes.  “And I sure as hell know how bad this is and how hard this decision is, even when it really shouldn’t be.”  Kirk marveled at her clarity and strength – and here he had been worried.  “I know you’re his proxy and I know you’ll make the right choice.”  Her eyes drifted in memory.  “He loves you so much,” she whispered softly. 

 

Kirk forced himself to hold it together.

 

Johanna met his eyes again.  That focus was back.  “You need to make that call,” she said, “but only if it’s the absolute last one to make.”

 

Kirk’s eyes widened. 

 

“I know I probably sound like I just can’t let go,” Johanna sighed, “but I need, and I think you do too, to know that there was absolutely nothing else we could have done.  No more chances.”

 

Kirk nodded for her to continue.  He found himself strangely comforted hearing Bones’ medical philosophy coming from Johanna’s lips.

 

“Is Nurse Chapel on duty?” Johanna asked.

 

Kirk nodded.

 

“I’d like to speak to her, please,” Johanna said.  “I have a few questions.  If, after you all talk again, there is no other choice, please contact me before you let him go.  I…..I want to be able to say goodbye.”

 

“Of course,” Kirk assured her.

 

“Thank you, Captain,” Johanna smiled softly as Kirk paused the transmission and asked Uhura to send it to the ICU terminal.

 

****

 

Christine whirled around at the sound of the comm.  “Sickbay, Chapel here,” she acknowledged, glancing over to the doors as Kirk walked back in.

 

“I have Johanna McCoy for you,” Uhura said.

 

Christine’s eyebrows went up.  She looked over at Kirk, who simply nodded.  “She wants to talk to you,” he confirmed.

 

Christine looked back at Uhura.  “Okay, put her through,” she shrugged.

 

Johanna’s face came into view.  “Hi, Chris,” she greeted.

 

“Hi, Jo,” Christine replied softly.  She had gotten to know Johanna a bit through her calls to Leonard – since he was usually in sickbay for one thing or another, he tended to take Johanna’s calls in his office, or call her when he found a few minutes between patients or lab results.  As Christine was often coming in and out of his office, they had been introduced, and once Johanna had started nursing school, Christine found herself offering tutoring services and support.

 

Johanna summarized her conversation with the Captain, then got to the point.  “I know it sounds ridiculous,” she began, “and if it hasn’t worked by now, it probably won’t, but, I have to know.”  She glanced down at a PADD in her hands.  “Daddy and I talked about Dr. Kerebus’ article a few days after it came out, just playing with some numbers.  Could you take a look?  I know ya’ll based your dosing schedule on some of his ideas, but I think these are different.”

 

Christine swallowed against the unavoidable rush of wild hope and the immediate soul-crushing reality that followed.  “Of course.  Send them over,” she offered.

 

Johanna sent the data and waited while Christine scrolled quickly through the information.  “The doses and scheduling are definitely different,” she noted.  “And he never mentioned thinking about adding another regen round.”

 

Johanna nodded.  “I know that the damage is done,” she said, “but if there’s even a _chance_ …..it’s not like it could get any worse,” she ended bitterly.

 

Christine knew the feeling.  “I’ll sit with the rest of the team and I’ll let you know,” she promised.

 

“Thanks, Chris,” Johanna let out a breath.  Her face tightened.  “Can I see him real quick?” she asked nervously.

 

“Of course,” Christine said, hitting a switch on the comm to transfer the message to the portable screen.  She turned to grab the rolling cart and was surprised to find the room empty.  She had never even heard them leave.  Shrugging, Christine wheeled the screen over to the bedside.  “Let me know if you have any questions,” she said softly.

 

Johanna’s breath hitched as she finally lost the battle, tears running freely down her face.  “Hold on, Daddy,” she whispered.  “Give this a chance before you make any hasty decisions, but if it doesn’t work and you need to go….” she stifled a sob, “then you go on and go.  Don’t hang around ‘cause of me, okay?”

 

Christine didn’t even bother to hide her own tears as Johanna thanked her and ended the communication.  Wiping her eyes, she wheeled the cart aside and transferred the data to the PADDs on the table.  Taking one last look at McCoy, she turned to the window and waved the group back in, explaining Johanna’s request.  Kirk nodded and headed straight for the bedside chair, pulling it close and resting his head on McCoy’s arm.  Spock offered his assistance should they need it before following Kirk to the bedside, standing guard over his friends. 

 

Christine handed the PADDs to Mara and M’Benga and quietly suggested they take their discussion elsewhere.  Mara nodded in agreement and they moved to McCoy’s office. 

 

“I know there’s an old quote that says insanity is doing the same thing over and over, expecting different results, but…..” she nodded toward the data in front of them.

 

“The hell with that,” Mara interjected.  “Insanity is practically this ship’s real name – how many times have our asses been saved by some insane idea?”  She began scrolling down the screen.  “What’ve we got?” she began the discussion.

 

M’Benga smiled and focused on his PADD.

 

Christine smiled ruefully.  It was going to be a long night.

**Notes for the Chapter:**

> Medical Notes:
> 
> \- Neurology has never been my specialty, so I have done what I can with some extra research for the EEG and cranial scan results. Checking to see that the pupils respond to light is a basic neurological test – the clinician is checking the size of the pupils, that they properly constrict when light hits them and that they constrict at a normal pace. Other neurological tests include asking a patient to follow simple verbal commands (such as following something with their eyes, or squeezing the clinician’s hands) and testing for reflex behaviors, such as the body’s natural response of moving away from a painful stimulus.  
> \- Johanna McCoy came out of nowhere and became an active part of this tale. As her character began forming in my head, she insisted that Bones had named her “Johanna with an ‘h’”, so that’s where that spelling came from. I know we don’t really have anything in TOS about her, so I just went with what she told me, from appearance, to personality, to professional goals.   
> \- The quote about insanity is attributed to Albert Einstein.


	8. Chapter 8

**Summary for the Chapter:**

> McCoy is critically injured and Christine Chapel does what she does best. A character study of Leonard McCoy and a look into the world of the Enterprise medical team.

 

 

“All right,” Christine breathed out, moving the last hour’s emotions to the corner of her brain reserved for bedtime ruminations with a weary, practiced hand.  Now was not their time.  “Johanna needs to know if any of this is viable,” she nodded at the PADD in her hands.

 

Mara looked up from her screen.  “You know, I thought we already used all of Leonard’s notes on that study when M’Benga and Kerebus worked out the original plan,” she said.

 

M’Benga voiced his own wonder at that point with a soft “hmmm” of agreement, never breaking focus.

 

“Don’t look at me,” Christine threw her hands up in mock frustration.  “He didn’t tell me either, and going by the date on these notes, it all came before the two of us ever sat down and reviewed anything.”

 

“Discussing potential medical breakthroughs with his daughter first,” Mara clicked her tongue disapprovingly, her eyes sparkling.  “I’m not sure how to feel about that.”

 

Christine chuckled.  She had to admit, though, that she _was_ curious.  While she certainly couldn’t account for all of McCoy’s time, the CMO _did_ spend the vast majority of it in sickbay, and since she did too, Christine usually had an idea what he was working on, even when it was a preliminary review he refused to share on the grounds that it “was probably nonsense.” 

 

_“Actually,”_ Christine thought to herself, _“that’s probably it – he jotted down some initial thoughts, but got rid of them after further review.”_   That made sense.  _“Still,”_ she wondered, looking at the times noted on the file, _“why didn’t I see him doing this?”_   It really shouldn’t have mattered – why was it bothering her so much?

 

As if reading her thoughts, Mara suddenly slapped the table.  “THAT’S when it was!” she shouted triumphantly.

 

M’Benga barely looked up, used to Mara’s rather boisterous manner.  Christine raised an eyebrow mildly, but her eyes pleaded for Mara to continue.

 

“I was trying to figure out when the hell he had time to work on this during those hours,” Mara explained, “since I remember working that shift and being completely swamped.  It was right after the whole Yonada thing.”

 

Christine’s memory came rushing back.  Of course!  It had been her turn on night shift rotation, and she had spent the majority of it working with M’Benga and Mr. Spock in administering the Fabrini xenopolycythemia treatment and monitoring Leonard’s response.  She had left the next morning, stressing the need for McCoy to rest in her report to Mara, because she knew Leonard wouldn’t listen the fifty times she stressed the same fact to him.  Obviously, her doubts were well-founded.  “I should have _known_ he’d find a way to work,” she swore out loud.

 

Mara burst out laughing, having watched Christine’s face cycle from memory to outburst.  “Does this really surprise you?” she snorted.

 

Christine welcomed the laugh.  “No, not really,” she admitted, almost fondly.  “But what is it about doctors acting just like the patients that drive us all nuts?  It’s not like Leonard didn’t have the damn knowledge to know that overtaxing a body that was still probably at high risk for clotting off from those blood counts was a bad idea,” she muttered.

 

M’Benga looked up mildly.

 

Mara smiled sweetly.  “Present company excluded, of course, Dr. M’Benga.  You _always_ listen to us nurses.”

 

Christine reddened, but couldn’t control the snort of laughter that escaped her tightly pressed lips.

 

M’Benga shook his head, barely managing to hide his smile as he went back to reading.

 

Christine sighed.  God, she had needed that.  Mara always knew how to break the tension and get everyone focused again.  The laughter warmed her gut, chasing off the icy claws of doubt.  Her head cleared and she drew in a deep, cleansing breath.  _“Okay, let’s do this,”_ she motivated herself.

 

“Okay,” Mara took her cue from Christine’s readiness and started summarizing.  “So, he was thinking of more frequent dosing, with a high dose loading period – 120 ccs q30 minutes for four hours, followed by the 60 ccs we’ve been doing, but q1 instead of q2.”

 

Christine nodded.  “I guess he figured hitting the damage hard and fast with the tri-ox would increase the potential for a positive outcome.”

 

M’Benga nodded.  “It does make sense,” he agreed.  “ _Immediately_ after injury.  With the time that has passed in Leonard’s case, I don’t know that it would be quite as efficacious.”

 

Mara agreed with a sigh.  “When does ‘irreversible’ _really_ become ‘irreversible’?  We’ve always known we have a window of opportunity to reclaim tissue, but we really have no exact time frame, especially in a case like this.  I mean, Leonard is kind of rewriting the book on post-arrest brain injury right now.”

 

“Isn’t that the truth,” Christine muttered.  She glanced back at her PADD.  “I think the transcutaneous regen might have worked with that protocol, but in Leonard’s case, it was never really an option, with the extent of the damage.  The fact that we still haven’t gotten significant results, even after direct regen, which he didn’t tolerate well _at all_ ,” Christine glanced at Mara, remembering the surgical report, “seems to suggest that further regen is out.”

 

Mara blew out a breath in frustration.  “The thing is, we’ve _never_ had great luck with cerebral regen,” she ranted.  “I mean, modern medicine has had amazing success with it for just about every other organ and tissue, but it only seems to have a varying effect on the brain stem, whether direct _or_ transcutaneous.  I don’t understand why those principles don’t follow with cerebral cells overall.”

 

“I share your frustration,” M’Benga’s soft voice came in.  “It simply comes down to the fact that even today, medicine can’t explain everything.”

 

“I know,” Mara ground out.  “I’m still pissed though.”

 

“Noted,” M’Benga smiled gently.

 

Christine sighed heavily.  “I think our biggest problem is that we’re taking a promising study and trying to apply it outside of the study’s parameters.  I mean, there was always the hope that the same protocols would work, but the fact remains that Dr. Kerebus was working with TBI.  We just can’t expect that the same research would work with hypoxic-ischemic injury, or in Leonard’s case, complete anoxic injury.  Especially on the scale of six minutes.”

 

“You are absolutely right,” M’Benga agreed.  “ _There_ is our problem.”

 

Christine felt those doubts start churning in her gut again.  “Are we just being selfish?” she finally asked, barely able to get her voice above a whisper. 

 

M’Benga was silent.  Mara chewed her lower lip, eyes bright.

 

“I mean,” Christine continued slowly, “even _if_ we came up with something, some insane way of giving him a chance at a normal life again……are we just prolonging a state he never wanted to be in in the first place?  And _if_ it worked, there’s no guarantee he would ever regain full function.  Hell, the frontal lobe damage _alone_ pretty much ensures he’d never be the same man.  Is it right to put him through all that?” she almost choked on the last few words.

 

Mara let a rare tear escape.  “Just because we _can_ , doesn’t mean we _should_?” she asked quietly, before her natural strength and sarcasm took over and she snorted a bitter, “Not like we have a ‘ _can_ ’ right now anyway.”

 

“Yeah,” Christine whispered.

 

M’Benga sighed.  “We should discuss this with Johanna and the Captain,” he said.

 

Mara lowered her head.  “She just found out her father was hurt and now we have to call her right back to say that he’s dead?” she asked angrily.  She shook her head.  “That’s my fault – I should have called her that night, once he was out of surgery.”

 

“It’s not your fault,” Christine insisted.  “I could have called her just as easily before I went off-shift after the whole incident, or during my next shift.  I can’t _believe_ it slipped my mind,” she berated herself.

 

“You were both occupied with keeping Leonard alive,” M’Benga cut in gently, but firmly.  “You knew Captain Kirk was his proxy and you were dealing with numerous complications on an already critical patient.  Do not discredit what you’ve done by berating yourselves.  As the attending physician, it was just as much my responsibility,” he pointed out.  “It happened.  It’s over.  We have other tasks at hand.”

 

The two women nodded miserably. 

 

“Are you ready?” M’Benga asked softly.

 

Mara swiped a hand across her face.  “No,” she breathed out, hard.  “Are you?” she asked, her voice tight with humorless sarcasm.

 

“No,” M’Benga said, “but if I wait until I _am_ ready, I will be waiting a long time.”

 

Christine nodded her understanding.  Drawing herself to her full height, she headed for the door, already dreading Kirk’s reaction.  “Let’s go,” she said tiredly.

 

“Are we sure?” Mara suddenly cut in, running her fingers through her red curls in a futile attempt to comfort herself.  “I mean, Johanna said she needed to know that there were _no_ other options, right?  What if we’re missing something?  I mean, besides the fact that we’re missing the knowledge or technology to make a damn difference.  I just…..I know it’s ridiculous, but I just feel like we’re _missing_ something.  Like it’s right here and we just don’t see it.”  She laughed bitterly, thinking back to McCoy’s notes.  “If only the Fabrini had thought of _this_ ,” she murmured.

 

“If only,” Christine agreed softly.  She wrapped an arm around Mara and followed M’Benga to the ICU. 

 

****

 

Christine knew they’d never even have to say a word.  Kirk was still in the same position – in the chair next to McCoy’s bed, head resting lightly on the physician’s arm.  He looked up at the swish of the doors and Christine almost had to turn away at the sheer devastation in his face as he swept their eyes, found his answer, and dropped his head back to McCoy’s forearm, a soft, strangled sound at the back of his throat the only vocalization of his shattered hope. 

 

Spock tightened his grip on both men and swallowed visibly, blinking his eyes just a touch too rapidly for a Vulcan. 

 

“It will not work,” Spock was the one to finally speak, his deep voice a perfectly even melding of frank statement, scientific curiosity, stunned disbelief and very human sorrow.

 

M’Benga shook his head and began explaining their discussion of Johanna’s notes.

 

Kirk finally lifted his head, eyes red.  “I understand why the tri-ox wouldn’t work,” he managed to find his voice, letting his analytical mind take over for a moment.  “It would be like throwing fuel on a pile of logs with no flame – the fuel doesn’t mean anything without a flame to feed off it.  Bones….” He took a moment to control the crack in his voice.  “Bones’ brain tissue is dead – giving it oxygen won’t make it function and use it.”

 

M’Benga nodded gently.

 

“What I don’t understand,” Kirk continued slowly, “is why the regeneration couldn’t work again,” he met their eyes pleadingly.

 

Mara stepped forward quietly.  “The regeneration units basically work on the principle of stem cell differentiation,” she began explaining.  “Stem cells are cells that can reproduce rapidly and become different types of tissue – they generally act as a sort of internal repair team.  They lie dormant until they’re triggered either by internal or external events, usually in response to a need to replenish dead or damaged cells around them.  They are located all over the human body – for example, stem cells found in cardiac tissue can be triggered to differentiate into new cardiac muscle cells when stimulated by local need.  That stimulation can be triggered internally, such as a gene in the cell’s DNA getting turned on and leading to the differentiation, or it can be external, such as by a chemical secretion from another cell.  The regen units basically target the local stem cells present in the damaged area and trigger that differentiation.  Unfortunately, they can only really provide external stimulation, such as chemical secretions, so some cells don’t respond as well if they are dependent on internal factors to begin the process.  As we saw with Leonard,” she paused to take in a shaky breath, “it works extremely well on cardiac tissue, but is only marginally effective on brain tissue, and even then, only on the brain stem.  It seems that the brain cells prefer internal stimulation, which the regen units just can’t do,” she finished, her fists clenched at her sides in frustration.

 

“And we have no way of…..internally stimulating those cells,” Kirk tested his understanding.

 

“No,” M’Benga confirmed quietly.

 

Kirk dropped his head again.  “We need to tell Johanna,” he said, voice muffled by the bed linens, as if he couldn’t bear to pull himself away for even a moment now.

 

 M’Benga nodded and headed for the comm.

 

Christine moved to the two grieving men across the bed and squeezed their arms gently.  She then walked back to the other side, and ghosted a gentle kiss across McCoy’s forehead.  Mara stood to her right, glaring furiously at the medical equipment surrounding McCoy as if her demand alone could be enough to extract an answer to the unfounded insistence in her gut.

 

Christine swore she wouldn’t cry.  Not yet.  She looked down at McCoy lovingly.  “You know, he wrote those notes while he was supposed to be resting after the Fabrini treatment,” she shared.  “Typical,” she chuckled softly, swallowing back the break that threatened her voice.

 

Spock suddenly snapped upright.  Christine winced, resisting the urge to make sure he hadn’t broken something.  “I am a fool!” he ground out.

 

Christine felt something flutter in her gut.  Mara almost stumbled forward.  Kirk didn’t move, but Christine could see the tension in his back.

 

“The medical banks of the Fabrini!” Spock was almost _bouncing_ , his eyes flitting from the medical staff, to McCoy’s face, to Kirk’s back.  “There was mention of a compound developed for cerebral damage, but abandoned due to difficulties in getting the medication to its desired location,” his gaze landed on Christine, and she nearly stumbled back at the force of the trust there.  She could practically hear his voice in her head – _“we can do this.”_

 

A sly smile bloomed on Mara’s face.  “Well, we have a goddamn shunt,” she said, “so if it’s a blood-brain barrier issue, we’ve already kicked its ass.”  She turned to Christine and clapped her hands loudly, the sudden snap punctuated by a determined grin.  “They DID think of it!” she grinned.

 

“We know nothing of the mechanism of action of this particular compound,” Spock reminded Mara, any hope of sternness destroyed by the thinly disguised hope in his eyes.

 

“Well, Mr. Spock,” Mara practically drawled, “that’s why we’re going to pull the records and figure it out.”

 

Christine forced herself to breathe, pushing aside the dizziness of the last forty-eight hours’ emotional rollercoaster.  She didn’t want to hope anymore.  It hurt too much when the reality of what they couldn’t fix crushed that hope to hell.  Yet…..finding herself pinned between Spock’s raw hope and Mara’s wild resolve, Christine couldn’t help but feel that hope tentatively take root again. 

 

Kirk had finally raised his head, that same wary hope flickering in his eyes.

 

M’Benga stepped forward.  “You’re his proxy, Captain,” he said softly.  “It’s up to you.”

 

Kirk’s gaze slid from Spock, to M’Benga, then Mara, and finally locked on Christine.  Apparently finding what he was looking for in her eyes, he straightened, grabbing McCoy’s hand tightly.  “Do it,” he ordered.  A small smile tugged at the corners of his lips.  “There’s no way I’m telling a McCoy that I ignored a potential medical breakthrough,” he said, the smile blooming into a full grin as he brought his gaze back to McCoy’s face.

 

“YES!” Mara shouted triumphantly. 

 

Spock rolled his eyes.  “Please contain yourself, Nurse Govannen.”

 

“Sorry, Mr. Spock,” Christine broke in, “but I’m with Mara.  Besides, someone needs to take over for Leonard.  Sickbay just isn’t sickbay without an emotional outburst.”

 

“Or two,” Mara grinned.

 

Spock sighed, but Christine could see that rare spark in his eyes, the one that he reserved for his battles with McCoy.

 

“Face it, Spock,” Kirk laughed.  God, it felt good to laugh, even if it was just for a moment.  “They’re right.”

 

Spock simply raised an eyebrow and headed for the doors with the rest of the medical team.

 

Christine drew in a deep breath, marveling at the sudden burst of energy just a few words had given all of them.  She remembered sitting with Leonard after the Vega V disaster, watching him stare sightlessly into his bourbon.  His mind wasn’t ready for sleep, although his body was way beyond need after spending the last forty hours on his feet fighting for Jim Kirk’s life.  She had given up trying to convince him to lie down, so instead, she sipped her own drink, sitting with the exhausted physician in companionable, supportive silence.  As if the dark liquid had finally given him the answer he needed, McCoy sighed heavily, scrubbing a hand across his face as he pushed the drink away and stood up, keeping his hip firmly in contact with the table for support that Christine wasn’t quite convinced would be enough. 

 

“I’ve always defined humanity in terms of compassion,” he began softly, his accent as thick as the exhaustion rolling off him in waves.  “It’s our greatest quality – we lose it, and we lose who we are.”

 

Christine forced herself to stay put as he swayed and caught himself on the table.  Leonard was an introspective man by nature, but never so openly.  Whatever had made him start talking needed to be finished. 

 

“But after today……yesterday….” He waved a hand ambiguously at the passage of time.  Christine considered it lucky that he knew his own name at this point.  “Well, I reckon I forgot about hope.”

 

Christine watched his glassy eyes trail off, a shudder running through his thin frame.  “Hope?” she prompted softly.

 

Cloudy blue snapped back into some semblance of focus.  “Hope,” he repeated breathily.  “I….I almost lost it, Chris,” he admitted, leaning heavily on the table.  “When Jim started bleedin’ out again…..all I could think about were the names of the lacerated vessels, the volume of blood a human being can lose before all our skill doesn’t make a damned bit of difference.  I always have hope…..that what we know will be enough, that what we don’t will suddenly come to us, that the universe isn’t _really_ out to kill us all,” he laughed shakily, but there was very little humor there.  “But for those few seconds, all I could see was darkness…..and silence.   I almost lost him,” he whispered, shuddering again.  He sucked in a breath.  “And I would have,” he said, convinced, “I would have lost Jim,” he forced himself to say the words, “If I didn’t suddenly have my mother shouting in my head.”  He looked like he wanted to smile ruefully, but just didn’t have the energy.  “I had a tendency to be somethin’ of a melancholy child.  She’d find me sittin’ alone under a tree and tell me, ‘Leonard, you gotta have hope, hope that this world’s not all bad.  It’s what keeps you human, and I’ll be damned if I raised a machine instead of a son!’”  He managed a weak chuckle.  “She was right though.  Soon as I brought it back, I knew what to do and that there was no damned way it was gonna do anything but work.  And it did,” he glanced at the door, as if reminding himself that Jim Kirk was indeed alive and recovering.  He finally met her eyes.  “Don’t ever lose hope on a patient, Chris,” he pleaded softly.  “We can’t lose that part of our humanity.”  His eyes cleared just a bit and he managed a weak laugh, but one with a hint of his usual warmth.  “And if I EVER lose it again, I swear, I’m giving you a medical order to slap me until I come to my damn senses, understood?”

 

Christine let out a half-laugh, half-sob.  “Understood, Doctor,” she said.

 

“I mean it, now,” McCoy had raised an eyebrow.  “Just pretend I’m Spock - healing trance or not - your choice,” he grinned.

 

Christine’s burst of laughter had been cut short as she bolted from her seat to catch McCoy as he crumpled to the floor.  She remembered watching that very humanity manifested in Spock as the Vulcan gently picked up the unconscious physician, cradling him closely as he brought McCoy back to sickbay so he could watch over both his friends, the hope for their recoveries plain in his dark eyes.

 

****

 

Christine brought herself back to the present, taking a seat at the main sickbay terminal for the ship’s medical library as M’Benga, Mara and Spock fanned out around her.     

 

Yes, she couldn’t help but hope.  None of them could.

 

It was what kept them human. 

**Notes for the Chapter:**

> Medical Notes:
> 
> \- All references to Yonada, the Fabrini and xenopolycythemia refer to the third season episode “For The World Is Hollow And I Have Touched The Sky.”  
> \- “It’s not like Leonard didn’t have the damn knowledge to know that overtaxing a body that was still probably at high risk for clotting off from those blood counts was a bad idea.” This line refers to a potential risk of xenopolycythemia as interpreted by the fact that there is a real disease called polycythemia vera, which is a blood disorder where the body produces too many red blood cells (also sometimes overproducing white blood cells and platelets). Since all those extra cells make the blood thicker, there is a high risk of everything literally getting “clogged up” and clots stopping blood flow to any part of the body, including the brain.   
> \- “So, he was thinking of more frequent dosing, with a high dose loading period – one hundred twenty ccs q30 minutes for four hours, followed by the sixty ccs we’ve been doing, but q1 instead of q2.” A loading dose generally means giving either more of a drug or giving a drug more frequently (or sometimes both) in order to build it up in the body before going to a regular dosing schedule. Again, “q” means “every” so q30 minutes is “every thirty minutes” and the abbreviated q1 and q2 stand for “every hour” and “every two hours” respectively.  
> \- TBI stands for “traumatic brain injury.” There is often a big difference in treating/prognosis for traumatic injury versus injury due to lack of oxygen. An interesting article recently came out referencing this very fact in the New England Journal of Medicine (http://www.latimes.com/news/nationworld/nation/la-sci-vegetative4-2010feb04,0,4078396.story).   
> \- Hypoxic means “insufficient blood flow to cells/tissues.” Ischemic means “insufficient blood flow to an organ.” Anoxic means “complete lack of oxygen.”  
> \- “Just because we can, doesn’t mean we should?” Medicine can do a lot of things, even more so in the future, but just because we can do something doesn’t mean we should – this is where a holistic view of the patient comes in, as well as ethics.  
> \- Oh, the regeneration units. The sickbay staff insisted on a real explanation for how they work, or at least as real as someone who isn’t from that time period could make up. All the information on stem cells that Mara explains in the function of the unit is based on fact. I actually really enjoyed doing that research :)


	9. Chapter 9

**Summary for the Chapter:**

> McCoy is critically injured and Christine Chapel does what she does best. A character study of Leonard McCoy and a look into the world of the Enterprise medical team.

 

 

Christine pulled her gaze from the terminal screen as Elise walked in tentatively, followed by Dr. Sanchez.  _“Must be quiet tonight,”_ she thought, still keeping half her attention on Spock’s attempt to give the computer as detailed a search query as possible. 

 

Sanchez leaned against the far wall, observing quietly, while Elise came right up to Christine.  Leaning down, she asked, “Got something?”

 

Christine nodded and filled her in on Johanna’s notes, their subsequent discussion and Spock’s recollection of the potentially useful Fabrini compound.  Elise nodded, trying to contain her hopeful smile.  “You guys need any help?” she asked.  “Is he due for anything?”

 

Christine leaned back in her chair, looking toward the ICU, then down at the PADD in her hands.  “I’m sure he is,” she realized, glancing at her orders.  She looked over at M’Benga.  “Should we keep going with Leonard’s current treatments?” she asked, gesturing at the PADD.

 

M’Benga pulled up the plan on his own screen.  After a moment’s review, he nodded.  “Yes, please,” he decided.  “I’m reluctant to change anything at this point – he may not be in the best shape, but he _is_ stable for the moment.  I don’t want to risk that changing while we review this new possibility.”

 

Christine agreed.  She motioned Elise closer and began scrolling down the PADD.  “He’s due for another tri-ox dose,” she pointed out.  She glanced up at the older nurse.  “Are you okay working with the shunt?” she asked.

 

Elise laughed.  “Okay with it?” she repeated, “Not really – it’s like getting sent back in time working with that thing, but to answer your question, I _can_ work with it.  I helped Mara a bit the other night and gave a few doses myself.”

 

Christine chuckled.  “Okay, good.  So, he’s due for another 60 ccs – there should still be some bandage material in the room.  He’s up for another dose of the anti-ileus meds,” Christine rolled her eyes in agreement as Elise snorted her opinion of that particular medication, “and, actually, if M’Benga wants to keep everything going, he’s probably about due for a new bag of demcorzen.  Once the a-fib broke, I didn’t bother to replace it, since I figured we’d be d/cing it.”

 

Elise nodded, grabbing a spare PADD from the desk and motioning for Christine to transfer the record.  After jotting a few notes for herself, she looked back at Christine.  “Anything else?  Preventatives?  UO?”

 

Christine swore.  “Dammit, I forgot to empty the bag for Mara.  If you could chart a last output for my shift and empty the bag, that’d be great.  As for preventatives…..I did a few rounds during my shift and the Captain is in there now….” She trailed off.

 

“So?” Elise challenged.  “Honey, if Leonard needs something, I’ll either figure out a way to do it so he can stay in the room, or he’ll have to leave for a moment.  What’s on your mind?”

 

Christine sighed.  “It’s not much, but there was a little more redness than I’d like to see near the sacrum.  The bed’s still on the usual precautions and I’ve done a few rounds with the skin sealant today, but……”

 

“But nothing,” Elise said firmly.  “There’s no way we’re having a sacral pressure ulcer on this ship.  I’ll do another round with the sealant and use some good old-fashioned pillows to augment the positioning.”

 

Christine smiled, relieved.  “Thanks, Elise,” she said sincerely.

 

“Not a problem,” Elise patted Christine’s arm reassuringly.  “You all go back to being brilliant,” she said seriously, before turning and heading for the ICU.

 

Christine brought her chair back down and leaned forward as Spock pulled up the Fabrini test results and began transferring the data to their PADDs. 

 

“I simply remember seeing the compound in the Fabrini knowledge banks,” Spock reminded them.  “I did not endeavor to research it further.”

 

“There was no need to do so at the time,” M’Benga assured the Vulcan, knowing how difficult it was for him _not_ to have all the answers.  “We welcome your analysis now.”

 

Spock tipped his head to the right in acknowledgement and directed his attention to the PADD in his hands.

 

The room fell silent as the group began reading.  A few moments later, Christine looked up at the soft swish of the ICU doors and saw Jim Kirk, looking lost, wandering in their direction.  She caught his eyes and nodded him over.  “Elise kick you out?” she whispered, as if speaking louder would take away any chance of their current research working. 

 

Kirk nodded, looking back over his shoulder at the now tinted windows.  “I offered to help when she said she needed to turn Bones, but she insisted.  Said I shouldn’t see him like that.”

 

Christine agreed.  “She’s right, Captain,” she said.  “Being a patient here comes with its fair share of indignities.  We’re trained to work with those – you aren’t.  We all have our roles in patient care – yours doesn’t include skin care, but it doesn’t make the role you’ll pick up again once you go back in that room any less important.”

 

Kirk nodded reluctantly. 

 

Christine gestured to the PADD in her lap.  “Would you like a copy?” she offered.

 

Kirk took one look at the page before shaking his head.  “I think I’d better leave that up to all of you,” he smiled ruefully.  “My…. _role_ has never really been one for medical research.”  He knew the basics of most of the Enterprise’s science sections, which was more than the majority of starship Captains could say, but that was it.  He trusted his crew to explain details when he needed to know them – otherwise he had full confidence in their abilities to do their jobs.  When it came to medical research, he could always count on Bones to explain everything.  Of course, sometimes he really _would_ go on explaining everything, bouncing high on his toes, grinning away at whatever new thing he had discovered, but one well-placed, “Bones” from Kirk and he’d tone it down just enough to give Kirk the highlights.

 

The ICU doors swished open again and Elise stuck her head out, motioning Kirk back inside.  Some of the tension melted from his body as he was able to go back to doing something useful.  He gave Christine a quick nod and strode out of the room.

 

Christine smiled and brought her attention back to the Fabrini data.  She was amazed at the amount of data they had been able to accumulate without being able to directly test the compound on live subjects.  Their simulated brain tissue was simply inspired, allowing the Fabrini to note compound action and suggest dosing regimens even while being unable to physically deliver the compound to live tissue.  Apparently, the Fabrini blood-brain barrier was almost identical to that of human beings, and since the Fabrini somehow never seemed to suffer from organic brain disease, there had never been much need to find ways to bypass that barrier.  Human medicine had other needs, and most medications that needed to be delivered to the brain were now chemically altered to do so, migrating there after intravenous or even subcutaneous administration.  Unfortunately, that chemical alteration didn’t work with everything.  Some drugs simply couldn’t survive the engineering, and trying to add the chemical structure needed for the drug to pass the blood-brain barrier simply destroyed the drug’s original effect – hence the fact that McCoy had a hundreds year old shunt in his head for tri-ox administration.

 

Christine continued down the data, feeling the Fabrini’s frustration.  She always found it fascinating comparing medical research between cultures – how equally brilliant minds light years from each other could simultaneously arrive at the same answer in the same way while other times diverging completely.  The fact that the Fabrini didn’t ever need to fix cerebral tissue in their own people begged the question of why they were even researching it in the first place.  Was it an accidental find?  Simple curiosity?  A love of learning? 

 

“This is incredible,” Christine whispered to herself.  The Fabrini compound appeared to work on the same stem cell principle as the Enterprise’s regeneration units, but without the machinery.  How two cultures separated by the vastness of space and time had reached the same general conclusion…..the odds seemed astronomical.  She continued to the final data summary and gasped.

 

“Holy shit,” Mara whispered slowly, almost reverently.  “Am I reading this right?!” she looked up frantically, seeking confirmation.

 

Christine’s heart was pounding in her chest.  It was as if the Fabrini had listened to their last discussion on the limits of cerebral regeneration and had not only tackled the issue, but took it a step further. 

 

Even M’Benga couldn’t hide his awe.  “It would appear they solved the issue of internal stimulation,” he said, unable to tear his eyes away from the screen.

 

“Solved?!” Mara scoffed.  “Hell, they took the whole tabula rasa concern right out of the picture!” 

 

Christine re-read the summary, her mind racing.  The compound not only tackled the problem of internal stimulation, but it also kept external factors in the treatment plan.  They had somehow figured out a way to create a drug that migrated to local cerebral stem cells where it read the cell’s entire genetic blueprint, and then started creating new stem cells.  The compound didn’t just lead to regular stem cell proliferation though – it was as if the drug literally read the minds of the stem cells, learning what factors they needed to be activated, and began replicating cells with the required genetic coding.  If a neural stem cell needed a certain transcription factor, the new cells made sure it was produced.  If they needed a certain gene to be turned on, they had it ready to go.  The new cells even secreted external chemicals for differentiation if necessary.  The cells then proliferated, differentiating not only themselves, but migrating to damaged areas and literally restoring the damaged cells – and they didn’t just restore the area with healthy, blank cells – they somehow managed to almost _nudge_ the damaged cells back to their original state, complete with old coded processes.  Christine couldn’t even begin to understand how it all actually _worked_ , but the facts were clear – with direct cerebral administration, the compound had the potential to literally restore dead tissue back to its original state without destroying the subtle processes that lead to such complexities as learned motor function and memory. 

 

“I can’t believe they could come up with this and not figure out a way to get it past the blood-brain barrier,” Mara was amazed.

 

“Well, look how _we’re_ going to get it there,” Christine pointed out.  “Like we ever thought of _that_ possibility.  Besides, look at us.  We can regenerate practically an entire heart, but not a brain.  We can’t all succeed everywhere.”

 

“Good point,” Mara acquiesced. 

 

M’Benga looked up.  “The first problem I can see,” he said, hating to be the one to bring it up, “is the dosing.  I am unfamiliar with Fabrini measurements and the tentative conversion we used for the xenopolycythemia treatment won’t appear to work here, as they seem to be using different measurements.  Mr. Spock, do you recall seeing a full listing of their measurement system anywhere?  If we had that, we might be able to extrapolate from our previous data.”

 

“I will attempt to locate such a list,” Spock resolved, turning back to the computer terminal.

 

Dr. Sanchez pushed away from the wall.  “I don’t know what kind of time frame you’re thinking of, Geoff,” he said to M’Benga, “but I can go wake up some of the lab staff and start synthesizing this compound while you work out the details.  McCoy is our only patient right now, and if anyone else comes in, you can just call me back.”

 

M’Benga nodded.  “Good idea,” he thanked Sanchez, transferring the data onto another PADD and handing it to the physician.  Sanchez usually spent most of his time in the laboratory anyway and he happened to be an excellent chemist.

 

Christine watched Sanchez rush out the door.  “All right, so we have this compound,” she hated the fact that there was no name for it, “and we have the shunt.  We’re working on the dosing issue,” she nodded at Spock, whose attention was firmly on the terminal screen.  “What else do we need?”

 

Mara thought for a moment.  “It would seem to make sense to keep the tri-ox going, wouldn’t it?  I mean, in terms of fuel, as the Captain put it, this kind of process will definitely need the raw energy.”

 

M’Benga nodded.  “Agreed,” he said.

 

Christine pulled up Johanna’s notes.  “What do you think of trying Leonard’s original tri-ox dosing?” she asked, nodding toward the numbers.  “We’re taking the suggested direct regen out of the equation, but, in theory, we’re simply replacing it with a chemical regen.  A new process like that could probably use a boost of energy to get it going, and doing the loading dose right before the first compound dose just might help move things along.”

 

M’Benga considered the numbers.  “In theory, it makes complete sense,” he said.  “And since this entire process is going to be by theory, we might as well try it,” he admitted.

 

Mara bit her lip and frowned at the PADD.  “Now, I know we don’t have anything to go off of here,” she began, “but Leonard _really_ didn’t like the direct cerebral regen.  I know this is chemical, and working off a different set of parameters, but it still seems close enough that he might react in a similar manner and I, for one, do _not_ want to spend the rest of the night continuously administering an experimental treatment with one hand while emptying the emergency drug stock on his coding ass with the other.”

 

Christine let out a breath.  She hadn’t thought of that, but Mara was right.  She didn’t need Spock to tell her that the odds were in favor of Leonard having difficulty with this treatment as well.  “Well,” she said, resolve kicking in, “we’ll sit and review the surgery, figure out where his vitals generally went wrong and have a full stock of emergency drugs and the cardio stimulator right at the bedside.  And you won’t be alone,” she added that last sentence as a firm afterthought.

 

Mara met Christine’s eyes.  “Chris, look at the time.  You and M’Benga are already _way_ past done and this hasn’t exactly been an easy day.”

 

Christine’s eyes flashed a challenge - _“If you think for one second that I’m going to leave now…..”_ \- but Mara didn’t back down.  Christine sighed, scrubbing both hands across her face.  “I know, Mar,” she said softly, “but you’re going to need two nurses for this  – one of us can administer the medications, the other monitor and be ready to treat any emergencies that come up.  If this is going to be anything like the last time, the first twenty-four hours are going to be the toughest.  We’ll nap in shifts if we have to.”

 

Mara opened her mouth to protest, but Christine cut her off.  “And don’t tell me you wouldn’t do the same damn thing if our positions were reversed,” she pointed a finger firmly at her coworker.

 

Mara deflated.  “Okay,” she admitted reluctantly, throwing her hands up in surrender.  “You’re right.”

 

Christine nodded, bringing her attention back to the PADD.  “Now,” she continued, “what about current treatments?  Do you want to keep everything going while we try this?” she asked M’Benga.

 

M’Benga pulled up a review of the last forty-eight hours’ assessment data as Elise walked in.  “You might want to d/c dialysis,” she smiled, waving a PADD at the group.  She looked at Christine.  “I saw he was due for another set of labs, so I pulled a renal profile and ran it.  BUN and creatinine are textbook perfect and the potassium is back within range.”

 

Christine smiled.  God, she loved good news.  She glanced over at M’Benga, who had pulled up that latest data alongside the other assessments.

 

M’Benga nodded.  “All right.  Let’s stop the dialysis, but keep the machine primed on standby just in case.”

 

“Mind if I do that now?” Elise asked, gesturing toward the ICU.  “I’m sure the Captain would appreciate some good news.”

 

M’Benga nodded.

 

“Do you want to switch back to the original nutrition formulation?” Christine piped up.  They had lowered the patch’s potassium with the renal failure, but with the kidneys functioning properly again, they didn’t want to risk McCoy going hypokalemic. 

 

“Yes, please,” M’Benga said.

 

Christine looked over at Elise, who nodded her understanding and headed for the medication cabinet for a new patch.

 

M’Benga looked back down at the PADD.  “We can also d/c the rinhepin when we return,” he decided.  “I’d like to keep the demcorzen going – hopefully it will help dissuade Leonard from attempting to return to a-fib.  Fluids can remain at their current rate, as well as sedation.  I’d still like full labs q4 for now.”

 

Christine and Mara noted the changes on their screens.

 

“Doctor, I believe I have found something useful,” Spock spoke up, transferring a short burst of text and its accompanying chart to their screens.

 

“Yes,” M’Benga murmured, reviewing the chart.  He pulled up the xenopolycythemia dosages and compared the names of the measurements.  “It would appear that there are approximately 1.75 _natad_ in one _kalad_.  We determined, based on the Fabrini showing us a glass containing one _kalad_ worth of liquid, that it is about 6 ccs, so….” M’Benga paused to do the math.

 

“One _natad_ equals 3.43 ccs,” Spock finished immediately, cutting the rest of the calculation off as he rounded to appropriately measurable medical doses.

 

Mara smirked.

 

“Thank you, Mr. Spock,” M’Benga acknowledged.  He turned to Christine and Mara.  “I am going to figure out a dosing schedule, if you two would like to discuss your plan,” he said, stifling a yawn and resting his chin in his hands as he leaned over the table.

 

Christine and Mara huddled together, reviewing the emergency situations from McCoy’s surgery, noting the trend of the vitals and the actions taken before and after.  Christine began making a list of medications to bring to the bedside.  Tapping the stylet on the PADD, she thought out loud, “You know, since we have the central line, it probably couldn’t hurt to set up some drips of these meds too, just in case he needs them for awhile.”

 

Mara agreed.  “Yeah, we could start with the hypo, but titrate the drip after that if he keeps having the same problem.  It’d be especially nice for those damn BP issues he had last time.”

 

Christine nodded and added a few vasoactive drips to the list, along with a selection of cardiac drugs.

 

Spock watched the medical staff work.  Clearing his throat, he rose to his feet.  “Doctor, if you do not require further assistance…..” he began.

 

M’Benga looked up.  “Of course, Mr. Spock.  Please,” he motioned toward ICU.  “Thank you for your help.”

 

Spock nodded and strode out of the room.

 

****

 

Twenty minutes later, Mara and Christine stood at the desk, arms piled with hypos, IV bags, and tubing, while M’Benga filled them in on his dosing plan.  Sanchez had just called to inform them that they had the compound production underway.

 

“Shall we?” Mara grinned tiredly, gesturing her pile toward ICU.

 

M’Benga drew in a deep breath and led the way.

 

Kirk looked up at their entrance, rubbing a tired hand across his eyes.  He watched the medical team expectantly.  Apparently, Spock hadn’t told him much.

 

M’Benga began explaining what they had found, detailing their plan to combine the Fabrini compound with Johanna’s notes on McCoy’s earlier tri-ox dosing.  Christine and Mara explained their plan to combat any potential repeat of McCoy’s previous intolerance to cerebral regen.

 

Kirk shook his head in disbelief.  “You mean to tell me we have a chance at getting Bones back?” he asked incredulously, unconsciously tightening his grip on his friend’s arm. 

 

“We have a chance,” M’Benga repeated, carefully dividing his voice between Kirk’s hope and a physician’s reservation.

 

“There’s no way Bones would turn down this opportunity, if this were any other patient,” Kirk said simply.  His inward gaze turned back to McCoy’s face.  “Are there any other risks to Bones?  It couldn’t possibly get any worse, right?” he asked.

 

Christine looked to M’Benga for confirmation before answering.  “No,” she said softly.

 

Kirk smiled ruefully.  “I didn’t think so,” he sighed.  Drawing in a deep breath, he turned to the medical team.  “An hour ago, Bones was dead.  I know I still might have to make that call, but Johanna entrusted me with making sure there were no other chances.  If this has even the _slightes_ t chance, we’ve got to take it.  Let’s get Johanna on the line.”

 

****

 

Ten minutes later, Lt. Slate had Johanna McCoy on the comm.  Her eyes were just as discerning as McCoy’s.  She swept the room, focusing on each of them individually before asking, “What do you have?”

 

Kirk couldn’t help but smile.  “We may have another call.”

 

Johanna’s eyes widened.  She looked to Christine and gestured rapidly.  “Well?  Out with it!” she insisted breathlessly.

 

Kirk glanced at Spock as Christine began filling Johanna in.  The Vulcan was watching Johanna intently, one eyebrow raised.  “I must agree, Captain, the resemblance is…..fascinating.”

 

Kirk laughed.  “Yeah, it’s a little unsettling, isn’t it?” he asked, glancing over his shoulder to McCoy’s still form.

 

“Indeed,” Spock agreed.

 

Christine finished her explanation, waiting for Johanna’s questions.

 

Johanna raised a hand to her face, worrying her lower lip as she thought.  Christine’s eyes were drawn to the glint of a ring.  How had she never noticed that before?  It looked identical to the one her father always had on his left pinky.  Johanna picked up on Christine’s gaze and twisted the ring shyly.  “They belonged to my grandparents,” she explained.  “Daddy wears _his_ daddy’s and I wear my grandmomma’s.”

 

Kirk smiled softly and filed that bit of information away into the growing folder of things he still didn’t know about his best friend.

 

Still worrying the ring, Johanna seemed to be trying to look past them, toward the biobed.  She pulled her attention back to Christine.  “When will we know if it’s having any effect?” she asked.

 

Christine looked to M’Benga.

 

“I know it’s all experimental,” Johanna clarified, “but an estimate.”

 

“I believe we’ll know within twenty-four hours if there is reason to continue,” M’Benga responded.

 

Johanna nodded, biting her lip, looking past them again.  She suddenly stomped her foot, covering her face.  “I should _be_ there,” she growled through her hands. 

 

“I know, Jo,” Christine soothed.

 

Johanna pulled her hands away from her face and took a deep breath.  The scientist’s calm took over.  “It has a chance,” she agreed, reviewing the data in her mind.  “And it _is_ fascinating,” she grinned.

 

Spock’s eyebrows disappeared into his hairline.

 

“Can you send me some of the studies, Chris?” Johanna asked.

 

“Sure,” Christine laughed.  Typical McCoy – couldn’t resist something new.

 

Johanna nodded, sobering slightly.  “Well, why’re ya’ll just standing there?  If you want my permission, you have it.”  She met Kirk’s eyes firmly.  “We have to make sure,” she said.

 

Kirk’s eyes blazed with commitment.

 

Johanna shifted her gaze back to Christine.  “Keep me updated,” she said quietly.

 

“Always,” Christine promised.

 

Johanna swallowed hard.  “Thank you.  All of you,” she said.  The screen went black.

 

It was M’Benga who finally broke the silence.  “All right,” he said, speaking to Christine and Mara.  “Begin the loading dose.  Dr. Sanchez informed me that the compound should be ready in three hours.  I’m going to try to get a little sleep before we begin that phase.  You should as well,” he pointed to Christine.  “I don’t anticipate any problems with the new tri-ox formulation, but normal emergency protocols stand.”  He stood up, stretching tiredly.  “Do not hesitate to wake me if there are any concerns,” he reminded them, heading for the doors.

 

“Thank you, Doctor,” Kirk said quietly.

 

M’Benga paused, giving Kirk a tight smile, before leaving the room.

 

“Okay,” Christine let out a breath.  “You want treatment or organization?” she asked, nodding between McCoy’s bed and the table piled high with emergency medications.

 

Mara bit back her first response.  “I’ll start the tri-ox,” she decided.  “Why don’t you organize the drugs, then grab a nap?  It’s just going to be q30 dosing for the next four hours – you might as well get some rest before we bring in the new stuff.”

 

Christine recognized her limits enough not to argue.  “Okay, but I’m grabbing a nap in the office in case you need a hand.”

 

Mara nodded her agreement.  “I’m going to go grab enough tri-ox for the next few hours, so we don’t have to keep coming in and out,” she said, jerking her head toward the doors.

 

“Sounds good,” Christine acknowledged.  “I’ll organize.”

 

Kirk finally stood up from his place at the comm, stretching tiredly.  “Will I be in the way over there?” he asked Christine, nodding toward the bedside chair.

 

“Captain, I believe Nurse Govannen just indicated that the next four hours are not critical,” Spock stepped in.

 

Kirk gave the Vulcan an exhausted, knowing smile.  “Sorry Spock, not this time,” he warned him.  “I’m not going anywhere until we know whether this new treatment works or not.”  He paused, thinking back to that first post-op report and hearing emergency protocol after emergency protocol being thrown at his friend to keep him alive.  “And if Bones doesn’t do well, I need to be here,” he swallowed.

 

Spock nodded.  “Understood,” he acknowledged.  His eyes shifted toward the chronometer.  “With your permission, there is a matter which requires my presence…..”

 

Kirk straightened.  “Of course, Spock,” he interrupted. 

 

“But,” Spock continued, “Request permission to return here once it is completed.  I assure you that, should I remain here in sickbay tonight, my efficiency on the Bridge tomorrow shall remain unchanged.” 

 

Kirk caught the subtle, ‘unlike what will happen to you when you stay up all night worrying and drag yourself to work you ridiculous human’ hidden in the deep layers of Spock’s voice.  “You know you don’t need my permission, Spock,” he said softly.  “And if it makes you happy, I’ll grab a few hours’ sleep in here.”

 

Spock folded his arms across his chest.  “It is not a matter of ‘making me happy’ Captain,” he pointed out.  “It is simply logical to rest when time permits.”

 

Kirk slapped Spock’s shoulder, chuckling.  “All right then, Mr. Spock, I shall do the _logical_ thing.”

 

Spock raised an eyebrow.  “A rare occurrence indeed,” he responded, dark eyes dancing with a humor carefully disguised elsewhere on his face as he left the room.

 

Kirk shook his head, still chuckling as he looked to Christine for an answer to his earlier question.

 

Christine smiled.  “We can work around you there,” she said, “but Mr. Spock is right – now is the time to sleep if you can.  There’s a cot in the closet over there if you want to set it up on this side of the bed,” she motioned to McCoy’s left side, which was devoid of central lines and shunts. 

 

Sometimes Kirk wondered how he got so lucky with the crew of the Enterprise.  “Thanks, Chris, I think I’ll take you up on that,” he replied, heading for the closet to set up his place next to McCoy.

 

Mara returned with an armful of tri-ox syringes and flushes just as Kirk was lying down.  Christine gave her emergency kit a final review, then headed to the bedside to begin taking down the rinhepin infusion.

 

Mara nudged her amiably, as she stepped alongside Christine to begin unwinding the shunt bandaging.

 

Christine nudged her back playfully as she switched over to Mara’s other side, adjusting the central line ports.  “Okay, I piggybacked the demcorzen into the white port with the fluids.  The virdipan is still by itself in the blue and the brown is open for anything else that comes up,” she said, giving the port one last flush.

 

Mara nodded as she passed the empty tri-ox syringe to Christine and began rewrapping the shunt site, grumbling at the charting system’s repetition of the treatment notation.  “Yes, I _know_ , I just said that,” Mara mumbled as the dry voice verified the treatment and time performed for the medical record.  She hated using the voice-recognition, but like Christine, she understood the value in taking the option out of surgery and putting it in critical cases like McCoy with nearly constant medications and treatments to be performed and charted.

 

“All right,” Christine yawned, “I’ll be in the office.”  She glanced at the chronometer.  “I’ll be back in three hours, so we can figure out how to do this.”

 

Mara nodded.  “Go,” she waved her off.  “Me and the tri-ox are going to get to know each other…… _very well_.”

 

Christine snorted back a laugh as she quietly passed a lightly dozing Jim Kirk and left the room.

 

****

 

Three hours later, Christine was back in the ICU, conferring quietly with Mara so as not to wake Captain Kirk.  Mara had brought two rolling treatment carts to McCoy’s right, one with Christine’s emergency supplies, the other divided neatly into piles of tri-ox syringes and the Fabrini compound.

 

“The last of the loading dose is due in twenty-five minutes,” Mara noted.  “I’ve got the audio prompts loaded for both the tri-ox and the Fabrini compound.  I really wanted to give it a name for the record, but something tells me ‘kickass cerebral regenin’ wouldn’t exactly be supported by Starfleet.  Maybe I could get Uhura to put it in Latin – _everything_ sounds academic in Latin,” Mara mused on that last point.

 

Christine burst out laughing, struggling to keep her voice down.  She nudged a few IV bags toward Mara, tapping the bed control that dropped another IV pole from the ceiling.  “Okay,” she got control of herself.  “I figured we could have a few drips primed and ready to hook up – maybe two of each – vasoactives, rate control, antiarrythmics…..” she glanced at the ventilator.  “He’s up to 18/12?” she asked, pleased.

 

“Yeah,” Mara acknowledged, stabbing tubing into another bag.  “Tidal volume’s still kind of crappy, but at least he’s initiating.”

 

Christine thought that over.  “We have vent orders, right?” she suddenly asked.

 

Mara picked up on Christine’s train of thought.  “Yup – M’Benga figured he might buck the vent at this point, with the brain stem improvement, so we’ve got permission to drop him down to CPAP or just O2 if necessary.”

 

“Good,” Christine murmured, clamping off the tubing on a bag of cordarone.  A spark found its way through the tired haze in her eyes.  “So, are you and the tri-ox attached now, or do you want the emergency drugs?”

 

Mara rolled her eyes dramatically.  “We’re really moving forward in our relationship.  Don’t deny me this chance, Chris.”  She finally lost it at Christine’s snort of laughter and burst out laughing herself.  “Really though, it’s up to you,” she finally managed.  “You’re the one already on the second shift.  Where do you feel comfortable?”

 

Christine thought for a minute.  “I actually feel pretty good after that nap,” she admitted.  “I’ll take the first round with the emergency drugs – we can switch off wherever we need to.”

 

Mara nodded in agreement and the two women fell into companionable silence, preparing their stations.

 

****

 

Thirty minutes later, Mara was disposing of the last tri-ox syringe from the loading doses, while Christine was readjusting the pillows she had moved under McCoy’s left side to lever his back off the bed.  Both women looked up as M’Benga walked in, followed by Mr. Spock.  Kirk sat up on the cot, as if sensing the change in atmosphere. 

 

M’Benga nodded to Kirk and walked over to Christina and Mara, while Spock took his place at Kirk’s side.

 

A few baseline scans later, M’Benga nodded to the two nurses and walked around to Kirk and Spock.  “We are ready to begin,” he stated.  “Mara will be administering the tri-ox every hour from this point on, per Leonard’s original notes, as well as giving the Fabrini compound every hour and a half for the first few hours.  Christine will be monitoring Leonard’s response to the treatment and is prepared to treat any conditions that may arise.”

 

Kirk nodded his understanding and leaned forward on the cot, reaching for McCoy’s arm.  Spock stepped forward as well, one hand on McCoy’s shoulder, the other lightly brushing Kirk’s sleeve.

 

Mara met M’Benga’s eyes briefly as she reached for the Fabrini compound and administered the first dose. 

 

The whole room held its breath, as if those first minutes would determine everything.  Christine shook her head, knowing it was ridiculous, but finding herself doing the same thing.

 

Five minutes passed and Christine finally broke the silence, stating a simple, “vitals stable” for the charting system to note.

 

M’Benga melted back against the far wall, observing quietly as time passed and Mara administered the next tri-ox dose, followed by the second of the Fabrini compound.

 

Christine stifled a yawn as she focused on the monitors.  “Vitals - ” she began to report, but stopped and frowned.  She looked down at her cart and opened the cardio stimulator case.

 

Kirk’s head whipped up, eyes frantically searching the monitors for the flash of an alarm.  “What is it?” he demanded.

 

“Nothing at the moment, Captain,” Christine reassured him.  She always told him the truth though.  “A little change in his heart rate and blood pressure – everything’s still well within normal range, but I like to be prepared.”

 

Kirk took a deep breath and let it out slowly, bringing his attention back to McCoy’s face, while trying not to glare at the monitors every few moments.

 

M’Benga had leaned forward slightly to read the monitors.  He nodded to Christine and leaned back against the wall.

 

The third dose was followed by a flash of yellow as the monitors chirped a warning.  “Heart rate 110, BP 90/40,” Christine informed the charting system calmly, reaching for a hypo and administering it swiftly.  “60 milligrams prometol given subcutaneously,” she stated, reaching over to the IV fluids and adjusting the pump.  “400 cc fluid bolus started.”  Five minutes later, Christine switched the pump back over to the regular fluid rate.  “Heart rate 80, BP 100/60, fluid bolus completed, initial rate resumed.”  She met Kirk’s worried gaze.  “Back to normal, sir,” she reported.

 

Kirk nodded his thanks, but gripped McCoy’s arm a little tighter.  “Watch it, Bones,” he growled softly.

 

Christine rearranged a few hypos on her cart and turned to the IV lines.  “Computer, state compatibility of IV virdipan and IV demcorzen,” she said. 

 

“Compatible,” the computer’s dry voice replied.

 

“Good,” Christine murmured, unhooking the sedation from the fluids and piggybacking it into the demcorzen instead.  She disconnected the fluids, flushed the line free, and hooked the single line back into the port, while pulling down the tubing from the new bag of vaspressin and piggybacking in the prometol.  She loaded the pumps, set standard initial doses and paused them, hooking the lines into the empty brown port on the central line. 

 

Mara leaned over.  “You feeling it too?” she whispered.

 

 Christine glanced away from Kirk’s unsuccessful attempts _not_ to notice what she was doing.  “Yeah,” she said, hoping that maybe, for once, their guts would be proved wrong.

 

Mara was administering the next tri-ox dose when the comm buzzed.  M’Benga strode over to the terminal.  “Sickbay, M’Benga here.”

 

“Scott here,” Scotty replied.  “Is Mr. Spock there?”

 

Spock walked to the screen.  “Yes, Mr. Scott,” he acknowledged.

 

“Might I be havin’ a word with ye in my quarters sir?” Scotty asked.

 

“Of course, Mr. Scott,” Spock said, “I am on my way.”

 

“Everything okay, Spock?” Kirk asked.

 

“I do not believe there is any reason for concern,” Spock replied, striding out of ICU.

 

Kirk watched the Vulcan’s back, unsure.  He sighed and brought his attention back to McCoy.

 

****

 

Half an hour later, as Mara was preparing to administer the fourth dose of the Fabrini compound, Spock reappeared in the doorway, followed by Scotty and Uhura.  Kirk sought out the time, confused.  Neither of them were on for another two hours.  His stomach sank – it had to be trouble.  Christine gave him a reassuring nod as he tore himself away from McCoy and trudged to the door.  Kirk motioned them to the corner, leaning against the wall so he could still see Bones past the group.  “Trouble?” he asked.

 

“I wouldn’t call it _trouble_ , Captain,” Scotty hedged.

 

“Well then, what _would_ you call it, Scotty?” Kirk sighed. 

 

“Well, Captain, it’s the engines, sir,” Scotty finally got out.

 

Kirk stiffened.  “What about the engines, Scotty?  I thought you said everything checked out fine after the flares.”

 

“Aye, sir, it did, and it still does.  All diagnostics report normal, but…..well, they just don’t _feel right_.”

 

“The engines don’t feel right?” Kirk clarified.

 

“Aye,” Scotty shook his head.  “I cannae put my finger on it, but…..”

 

“But nothing, Scotty,” Kirk insisted, “if you think something’s wrong, then something’s wrong.”  Kirk had long since given up trying to understand Scotty’s intimate relationship with the Enterprise.  After Spock’s report of Scotty’s role in getting the ship back to the Kalandan planet, he had renewed his resolve to never doubt the engineer’s feelings.  Hell, if Bones could feel something off medically with a crewmember, Scotty could feel something off with the ship’s engines.

 

The monitors chirped in warning, flashing yellow again.  Kirk strained to see past Scotty’s shoulder.

 

“Same thing as before, Captain,” Christine called out, “ but he’s responding again,” she nodded at the hypo in her hands.

 

Kirk sagged against the wall, as Scotty and Uhura brought nervous glances back from McCoy to their Captain.  “Recommendations?” Kirk asked Scotty.

 

“Well sir, I’d like to get her to Starbase 8,” Scotty said.

 

“Starbase 8?” Kirk repeated.  That was almost two days travel from where they were.

 

“Aye, Captain,” Scotty nodded.  “I know the chief engineer over there – I will nae trust just anybody with the lass.”

 

“Understood, Scotty,” Kirk began, “but are you sure we’re okay to get there?  I mean, there are closer starbases if you think she’s in that much trouble.”

 

Scotty shook his head.  “Gunny _understands_ starships, Captain,” he insisted.  “I cannae guarantee another engineer not just laughin’ me right off the base.  She’ll make it there,” he patted the wall affectionately.

 

Kirk nodded.  “All right, Scotty.  Why don’t you contact this engineer and give him an idea of what he’s in for…..” Kirk trailed off as Uhura stepped forward.

 

“Actually, Captain, we can’t contact anyone at the moment,” Uhura reported nervously.

 

Kirk sighed.  It was always something.  “Communications are down too?” he asked wearily.

 

“Not down, sir,” Uhura clarified.  “It’s just that we seem to be having trouble getting transmissions out.”

 

“Didn’t we just send Starfleet acknowledgement of our new orders recently?” Kirk tried to figure out where everything had gone wrong.

 

“Aye, sir,” Uhura said.  “The problem just started two hours ago.  Diagnostics are all coming up normal.”

 

Kirk looked at Spock.

 

“Lt. Uhura is correct, Captain,” Spock affirmed.  “I am unable to locate an explanation.”

 

Kirk scrubbed his hands across his face.  “Are we able to get transmissions _in_?” he asked.

 

“Not reliably, sir,” Uhura reported.

 

Kirk groaned.  “Scotty, how fast can we get there with the engines in…..whatever shape they’re in?”

 

Scotty smiled.  “Oh, I think I can coax ‘em to warp nine, sir.”

 

“Warp nine?!  Scotty…..” Kirk was baffled.  If Scotty was that worried, he would _never_ push his engines so hard.

 

“It would be nice to be so close to Earth for even a little bit, wouldn’t it Mr. Scott?” Uhura asked demurely.

 

Kirk was sure his eyes were about to fall out of his skull.  What the hell…….

 

Oh.

 

Scotty was grinning away, Uhura had that mischievous glint in her eye, and Spock was rocking ever so slightly on his heels, staring pointedly at Kirk, as if wondering how thick his Captain really was.

 

He must have been more exhausted than he thought.

 

Kirk pulled himself together, trying to hide the smile tugging at his lips.  “Am I to assume that we will be beaming more than an engineer on board this vessel once we ignore our mission and warp to a starbase that is quite out of our way?”

 

“Captain!”  Scotty was offended.  “I would _never_ beam unauthorized personnel aboard the Enterprise.”  He paused, unable to hide his grin.  “But…..if there happened to be a wee lass in orbit related to the man that’s saved all our lives at one time o’ another…..”

 

Kirk felt a surge of affection for these men and women.  How _had_ he gotten so lucky?  This certainly wouldn’t be the first time the Enterprise bent the rules, but they _had_ acknowledged that new assignment, and beaming unauthorized civilians onto a starship was definitely against regulations…..

 

Spock seemed to sense Kirk’s internal battle.  “Jim,” he said softly, “there is no scientific reason why the Enterprise must begin mapping those flares at the ordered date.  That region of space and its flares have not changed in 50.3 years and there is no evidence to indicate any change any time soon.”

 

Kirk met the Vulcan’s eyes, taking strength from the quiet determination there.  _“Regulations,”_ he muttered to himself.  _“Since when have I ever cared about regulations?”_   He thought back to his conversation with Starfleet Command regarding McCoy’s xenopolycythemia diagnosis – they hadn’t even attempted to fake concern.  Kirk was basically told to let McCoy stay on Yonada, despite the fact that blowing the ship/world out of the sky so it wouldn’t collide with Daran V was still a very real possibility.  Command would send him a new CMO and that was that.  Kirk felt his fists clench as the anger came flooding back.  _“No,”_ he decided silently.  _“This time we do it our way.  Besides,”_ he thought to himself, _“Bones is a Starfleet officer.  If my duty lies with Starfleet, then surely, my highest duty is to the officers that make the fleet.”_   Kirk nodded smugly to himself.  Even Spock couldn’t argue that logic.

 

Kirk pulled himself back to the present.  “Well,” he put on his best Captain’s voice, “far be it from me to disregard the recommendations of my Chief Engineer, Head of Communications, and First Officer.”  He winked at Uhura.  “Lieutenant, you said we can’t get any transmissions out?”

 

“Oh, I believe I can manage something, Captain,” Uhura grinned. 

 

“All right,” Kirk smiled.  “Spock, have the navigator plot a course for Starbase 8.  Helm can begin at maximum warp as soon as Scotty’s ready.  Uhura, if you’ll send the transmission down here, I’ll let Johanna know.  Dismissed.  And thank you,” he added sincerely.

 

Uhura and Scotty smiled, glanced over at McCoy and the medical team once, then left for their respective stations. 

 

Kirk sidled over to Spock, who was just stepping away from the comm.  “This was all _your_ idea, wasn’t it?” He gestured toward the ICU doors, where Scotty and Uhura had just left.  “When you went sneaking off before.”

 

Spock rolled his eyes, taking up his most Vulcan expression.  “Really, Captain, I have no idea what you’re talking about.  And I certainly did not _sneak_ anywhere.”

 

“No, of course not,” Kirk apologized, teasingly.  He met Spock’s dark eyes.  “Thank you.”

 

Spock merely inclined his head in acknowledgement before returning to McCoy’s bedside.

 

Kirk glanced at Christine and Mara for confirmation that everything was all right, before settling down at the comm.  A moment later, Uhura’s voice came over the speakers, followed by Johanna’s anxious face.

 

“He’s all right,” Kirk assured Johanna, trying not to feel slighted as the young woman strained to see past him toward the biobed for herself.

 

“He’s all right,” Christine confirmed, calling out from her place at McCoy’s side.  “He’s had four doses of the Fabrini compound – there have been two slight tachycardic and hypotensive episodes, but he bounced right back with a bolus and some prometol.”

 

“How slight is _slight_?” Johanna demanded.

 

“Heart rate 110, BP 90 systolic,” Christine recited.  “He’s come right back to 80s and low 100s, respectively.”

 

Johanna finally relaxed.  “Okay,” she acknowledged.  “Thanks, Chris.”

 

“No problem,” Christine called back.

 

Johanna turned back to Kirk and frowned at the grin on his face.  “Am I missing something, Captain?” she narrowed her eyes.

 

Kirk leaned forward.  “How soon could you get to Starbase 8?” he asked.

 

Johanna’s eyes widened.  “I’m already on my way,” she almost bolted from her seat.

 

“Seriously, Johanna,” Kirk insisted.  “If you can get there in the next twenty-four hours, we’ll be there.  You need to stay in orbit though, and……don’t mention your father’s name.  Starfleet doesn’t exactly know what’s going on with Bones,” he rubbed the back of his neck, embarrassed. 

 

Johanna grinned knowingly.  “Not a problem, Captain.  Daddy has a colleague at Atlanta General who runs a medical transport business on the side - ships with warp capabilities to get folks to their loved ones when they get sick on the other side of the galaxy.  He doesn’t need a name for the flight plan, and Starbase 8 has a small medical facility, so that’ll do for reason.”

 

“Are you sure – “ Kirk began.

 

“With all due respect, Captain, why’re we still talkin’ about this?” Johanna interrupted.  “I’m already on my way.  McCoy out.”

 

Kirk stared at the blank screen in disbelief.  Chuckling, he dragged himself upright and headed for McCoy’s side.  He glanced across the bed, where Christine and Mara were deep in discussion, the next dose of the Fabrini compound dangling from Mara’s hand.  Kirk frowned at the look in both women’s eyes.  He didn’t understand – Bones had already gotten four doses – he was fine.

 

Mara administered the fifth dose and everything went to hell.

 

The monitor flashed frantic red, critical alarms screaming while the ventilator shrieked unmercifully. 

 

“Mara, hit the vaso and open up those fluids!” Christine shouted, grabbing two hypos and emptying them in rapid succession.

 

Mara slammed the start button on the vaspressin and pulled open the IV pump holding the fluids, letting the tubing drop as she opened the clamp all the way.

 

M’Benga was at their side in an instant, adjusting the ventilator.  “Keep talking,” he urged Christine and Mara.  “What do you have?”

 

“BP’s 60/30 – fluids wide open, vaso at 20 mikes with a 20 mike bolus.  Heart rate 190 – no response to 60 milligram prometol bolus.”

 

“Got it,” Mara reached over and started the prometol infusion.  “His sats are shit, Doc; he’s too tachypneic to pull anything in.”

 

“I’ve just dropped him to CPAP – he has nothing to fight against now.  O2 at 100%,” M’Benga said.

 

“Dammit Leonard, it’s off, stop fighting it,” Christine growled, watching his respirations.  “He’s gonna go alkalotic…..you want to up the sedation?”

 

“Another 15 mikes,” M’Benga ordered.

 

Christine nudged the sedation up and winced as the monitors screamed even louder. 

 

“Shit!” Mara spat.  “Heart rate’s up to 200, BP just dropped to 54 systolic.”

 

“Increase the vaso another 20 mikes,” M’Benga ordered.  “He’s not responding to the prometol – give 20 milligrams of labtolol now.”

 

Christine grabbed the hypo and administered the labtolol while Mara upped the vaspressin.  Reaching up, Christine grabbed the labtolol drip, pulled down the prometol and started the new infusion. 

 

“BP 68/40,” Mara reported, glancing up as Elise came running in.  “Elise, grab another bag or two of fluids, will you?”

 

“You got it!” Elise ran off.

 

All Kirk could do was stare, wincing as the alarms screamed, trying to follow the orders that flew back and forth between the medical staff.  He thought it would be easier to deal with if he could be at Bones’ side, hearing and seeing everything.  Boy, was he wrong.

 

“Heart rate’s coming down…..140…….110….” Christine noted.

 

“Respirations 16, sat’s 88%,” M’Benga put in.

 

“BP holding just under 70 systolic,” Mara informed them.  “It won’t budge.”

 

“If we up the vaso anymore, we’re going to have to fight for his fingers,” Christine muttered.  “And we can’t keep up the fluids like this for long – he’ll drown.”  Her eyes ran over the hypos in front of her.  “You want a small synephrine bolus until the heart rate comes down a little more?” she offered M’Benga.

 

“Go ahead,” M’Benga agreed.

 

Christine let out a breath as the hypo hissed against McCoy’s skin.  Elise ran in, passing two primed fluid bags to Mara, eyes flicking to the monitors.

 

“BP 80/40 and rising,” Mara reported.

                                  

“Respirations 10, sat’s 95%,” M’Benga said.  “Please bring the sedation back down to the original dose.”

 

Mara reached over and decreased the dose.

 

“Heart rate 80…...oh no you don’t!” Christine suddenly shouted, grabbing a hypo of atropine.  “Mara, cut the labtolol down, he just dropped to 30,” she ordered, emptying the hypo into McCoy’s arm.  “1 milligram atropine,” she stated, eyes fixed on the monitors.

 

“Heart rate up to 40….and holding,” Mara noted.

 

“Dammit, Leonard, we regenerated most of your damn heart – you have no excuse not to use it,” Christine grumbled, giving another milligram of atropine.

 

“Respirations are down to 8, switching back to SIMV 12,” M’Benga said, fingers moving swiftly over the ventilator controls.

 

“Heart rate 64 and holding,” Christine reported.

 

“BP 94/60 and holding,” Mara added.

 

“I’ll take it,” M’Benga sighed heavily.

 

Christine and Mara leaned against each other for a moment before huddling with M’Benga to discuss current vitals and drip dosages.  Elise started clearing empty hypos from the bedside, noting what medications they ran out of, and heading for the medication cabinet for replacements.

 

Once the medical team had finished talking and had reestablished their stations, Kirk finally spoke up.  “What the _hell_ just happened?” he asked.  He was shaking.  He couldn’t understand how they weren’t. 

 

“Apparently, Leonard doesn’t tolerate cerebral regeneration in _any_ form,” M’Benga said wearily.  “His entire system……” M’Benga searched for the right word.

 

“Freaks out?” Mara offered, preparing another tri-ox dose.

 

“Pretty much,” M’Benga agreed.

 

“But why now?  He did all right with the earlier doses,” Kirk pointed out.

 

“Sometimes it takes several exposures before a problem occurs, kind of like an allergy,” Christine explained.

 

“But you saw it coming,” Kirk fixed her with a knowing look.  “I saw you two looking at each other, preparing medications,” he waved toward the IV drips.

 

“We saw small changes that had the potential to lead to larger ones,” Christine insisted.

 

Kirk shook his head.  “This ship and its _guts_ ,” he thought to himself.  Scotty could _feel_ when the ship’s engines were off.  Bones just _knew_ something was wrong with Spock when he was in the beginnings of pon farr……and that something just wasn’t right with Dr. Adams and Tantalus colony.  Even Kirk himself relied on those sudden gut instincts in the middle of a diplomatic negotiation or ship-to-ship battle.  _“No,”_ he thought quietly, _“Chris and Mara knew something was going to happen, and if their guts hadn’t led them to get those medications ready, Bones may not have gotten through this mess.”_

 

Kirk felt Spock shift next to him and looked up.  “Damn!” he swore softly as his eyes fell on the chronometer.  His shift started in fifteen minutes.  He couldn’t leave Bones now.  Besides, they were just making a straight run to Starbase 8 now.  It wasn’t like he had to supervise anything – helm and navigation could handle that.  Still, he felt the guilt creeping up on him…..he _was_ supposed to be on duty…..

 

Spock gave McCoy’s shoulder a gentle squeeze before turning to Kirk.  “Captain, with your permission, I will attend to the Bridge,” he said quietly.

 

“Spock…..” Kirk could see the offer in the Vulcan’s eyes.  “I won’t ask you to cover the Bridge,” he said.

 

“No, Jim, but I could offer and you could accept,” Spock insisted gently.  “There is no reason for both of us to be on the Bridge right now.  Your place is here.”

 

Kirk swallowed, hard.  “But….” he began.

 

“You allowed me to watch over Doctor McCoy during his surgery,” Spock reminded Kirk.  “Now I am….. ‘returning the favor.’”

 

Kirk nodded.  “Thank you, Spock,” he said quietly.  “Remember that you don’t have to be up there all day either.”

 

Spock nodded his understanding and left for the Bridge.

 

****

 

The rest of the day was a blur for Kirk.  Bones continued fighting the Fabrini compound for the next several hours, each dose leading to what Kirk could only call the “controlled chaos” of emergency protocol.  Christine, Mara, and M’Benga fought back with everything they had, coaxing Bones’ vital signs back to stability with an arsenal of medications and shouted encouragement.  As the hours dragged on, the medical language became a little more technical while the shouts became a little less so.  Kirk marveled at M’Benga’s continuous veneer of calm, Mara’s impressive vocabulary of Orion curse words, and Christine’s steady focus, her brilliance punctuated by an equally impressive ability to rant when Bones insisted on deviating from their careful chemical balancing act.

 

The day was winding into night when M’Benga decided to cut the Fabrini compound doses back to every three hours instead of every hour and a half.  Kirk drew in a shuddering breath as he watched Christine finally remove the cardio stimulator from Bones’ chest.  Somewhere back around dinner time, Kirk had found himself hurriedly shoved aside as Christine Chapel rushed into his space, thrusting the cardio stimulator on Bones and shouting out settings while Mara injected medications into the IV and M’Benga administered hypos, all while “v-tach” and “v-fib” flew across the bed until the staff finally let out a collective breath and declared a stable sinus rhythm.  Kirk’s ears still rang with M’Benga’s gritted “come on, Leonard”, Mara’s “sonofabitch, Leonard, USE that goddamn HEART!” and Christine’s breathless “don’t you DARE, Leonard” as she found herself doing chest compressions for the second time in three days. 

 

Kirk looked up warily as Christine drew back, placing the machine in its open case on the treatment cart. 

 

“He’s stable for now, Captain,” Christine replied wearily.

 

Bones remained stable as the night drew on, Christine and Mara swapping medication duties while the other grabbed a quick nap.  Kirk dozed restlessly, head on McCoy’s arm, while Spock, who had returned a few hours after dinner, stood at Kirk’s shoulder.  M’Benga had retired to the office for a few hours’ sleep.

 

Christine had just come back in from an hour’s rest and was preparing to send Mara out when the ventilator alarmed.

 

Kirk’s head snapped up.  “Please, not again,” he whispered.

 

Mara glanced at the reading before running out the door for M’Benga.

 

Christine pushed a few buttons on the machine, laying a hand on McCoy’s arm.  “Easy, Leonard,” she soothed.  “It’s just CPAP now – come on, show me what you can do.”

 

Kirk watched as McCoy started to breathe easier.  “What did you do?” he asked Christine.

 

“I changed the ventilator setting so that he takes all his own breaths,” Christine said.  “All the machine is doing is giving him oxygen and a little extra pressure to help move air in and out.”

 

“So, he’s breathing completely on his own right now?” Kirk dared to hope.

 

“Yep,” Christine smiled, running her hand gently along McCoy’s arm.

 

Mara returned, M’Benga on her heels.  “He’s on CPAP?” M’Benga noted.

 

“Satting 96% with a rate of 12,” Christine said proudly.

 

M’Benga smiled back.  “Well, it has been nearly twenty-four hours since we started the Fabrini’s treatment – if Leonard is trying to tell us something, I suppose it’s time we found out.”

 

Christine nodded and turned off the sedation.  “Talk to him, Captain,” she said gently.

 

Kirk swallowed against the sudden feeling of déjà vu as McCoy’s eyelids fluttered.  “Bones?” he asked quietly, almost reverently.  _“Please…..please let it be working,”_ Kirk pleaded silently.

 

Spock’s grip tightened on both Kirk and McCoy.  “Open your eyes, Doctor,” he whispered.

 

“Come on, Bones!”  Kirk found himself in the same position as before, leaning over McCoy, patting his face gently.  “Open your eyes.”

 

Hazel met blue.

 

“Bones?” Kirk choked out.

 

Christine wasn’t sure if she was imagining it, but she could have sworn McCoy’s eyes narrowed slightly, one eyebrow quirking in a weak imitation of his usual expression of confusion.

 

“Bones, look at me,” Kirk pleaded.

 

This time, there was no mistaking it.  McCoy blinked his eyes twice, narrowing them again in an attempt at concentration.

 

“Over here, Bones,” Kirk barely managed to get out, gently tapping McCoy’s cheek.

 

Christine’s own eyes blurred as McCoy slowly shifted his gaze to the left, hazy blue focusing on James T. Kirk.

 

Kirk let out a half-laugh, half-sob as M’Benga came up quietly behind him, penlight in hand.

 

“Excuse me for a moment, Captain,” M’Benga apologized, stepping in.  “Leonard, I apologize in advance for the light,” he smiled, testing McCoy’s pupil response.  He moved a finger slowly in McCoy’s line of vision, smile widening as McCoy slowly, shakily, tracked the motion.  M’Benga moved back, and nodded to Christine, who took McCoy’s right hand, motioning for Kirk to take his left. 

 

“Leonard, squeeze my hand,” Christine said clearly, squeezing once.

 

McCoy blinked hard, beginning to lose his battle with consciousness, as his gaze slowly slid to the right and fell on Christine.  After a few tries, cloudy blue snapped into focus, and Christine felt the slightest of pressure as McCoy’s fingers barely contracted.  Kirk’s sharp intake of breath proved it was bilateral.

 

McCoy’s eyes drifted to the left again, landing on Spock, then returning to Kirk.  He struggled against increasingly heavy lids.  “It’s okay, Bones,” Kirk whispered, almost tenderly.  “Go to sleep.”

 

His eyes slid shut.

 

Kirk was almost afraid to look away.  “I didn’t just imagine that, right?” he asked, not caring how ridiculous he may sound.

 

“No, Captain, you did not,” Spock assured him.

 

Kirk looked up at M’Benga.  “That’s normal, right?” he asked.  “You said earlier that the first time he’d wake up wouldn’t be for long.”

 

“You are correct, Captain,” M’Benga said.  “Those few moments took all Leonard’s energy – his body needs the rest.”

 

“I know it’s too early to know anything for sure,” Kirk began, “but this was a good sign right?”

 

“A very good sign,” M’Benga agreed.  “Leonard was able to focus for short periods of time, he followed my finger with some difficulty, but he still did so, and he responded to verbal command.  Those are very promising signs, but remember, it is still early.  We don’t know how much more function he will regain.”

 

Kirk nodded, exhausted.  He snapped to attention as the ventilator beeped.

 

“It’s okay,” Christine assured him as Mara quickly adjusted the settings.  “He just needs to go back on the old setting.  Until he regains some more strength, it’s normal to need a little extra support while sleeping.”

 

Kirk collapsed back against the chair.

 

****

 

An hour later, Dr. Sanchez, Elise, and Tom filed into ICU for report, insisting that everyone get some rest.  Spock followed a stumbling Kirk out, reminding the Captain that Elise had just promised to call him with any changes.  M’Benga nodded to Christine and Mara, giving them a knowing smile before heading for his quarters. 

 

Mara enveloped Christine in a quick hug as they reached the main sickbay doors.  “Dammit, Chris, I think we might really do this,” she laughed, completely worn out.

 

Christine thought of Johanna, on her way to her father’s side.  “I hope so,” she whispered as she and Mara parted ways.

 

Christine trudged into her quarters, barely making it to the bed before falling over.  She barely had time to kick off her boots before that little corner of her brain exploded, flooding her mind with images and emotions from the last several hours. 

 

Clinically, Christine knew it was still too early to know anything.  They had no idea if the treatment would continue to take, what Leonard’s brain looked like now, and if he would even tolerate another twenty-four hours of the compound.  Just because he had followed several basic commands today, didn’t mean he’d ever regain full motor control, speech, or memory.

 

Despite all that, Christine kept seeing those blue eyes shift and focus on her.  They were hazy, cloudy with exhaustion and confusion, and struggling to focus, but there was something there.  It may not have been the spark she so desperately missed, but they weren’t just “blue” anymore.  Christine swore she saw some of that story there again….the biography blurry, like trying to read through the rain, but _there_.

 

By some strange path of circumstances, Leonard had a chance.

 

Christine finally let go and let the tears fall.    

**Notes for the Chapter:**

> Medical Notes:
> 
> \- d/c stands for “discontinue.”  
> \- Again, the discussion on stem cells is based on current research. It has been expanded as to future possibilities.  
> \- “Hypokalemic” means low potassium, which can be dangerous for the heart.  
> \- 18/12 means that the ventilator is delivering 12 breaths per minute, but the patient is taking a total of 18 breaths, indicating they are taking 6 breaths on their own.  
> \- “Tidal volume” refers to the amount of air taken in on each breath.  
> \- “Bucking the vent” is another term for fighting the ventilator.  
> \- CPAP stands for “continuous positive airway pressure.” While the patient is taking all their breaths on their own, the ventilator adds just a little pressure on inspiration to help bring air in, and adds a little pressure on exhalation, to help keep the alveoli (small air sacs where gas exchange takes place in the lungs) open.  
> \- When Christine is checking the compatibility of IV medications, she is making sure that it is chemically safe to mix them in the same IV tubing.  
> \- Scotty and the whole “engines not feeling right”, and his subsequent brilliance in getting the ship back to the Kalandan planet refers to the third season episode “That Which Survives.”   
> \- I have to thank MaryChodan with inspiring me for the scene where Kirk recalls his anger at Starfleet’s treatment of McCoy’s xenopolycythemia diagnosis. I was looking for a tie-in, and her comment brought it right out!  
> \- “Systolic” refers to the top number in a blood pressure reading.  
> \- A “mike” is a shortened version of “microgram.”  
> \- “Tachypneic” means the patient’s respiratory rate is too fast. A patient can become alkalotic is this continues, meaning that the patient breathes out too much carbon dioxide (an acid), leaving the body’s pH too far on the basic side (higher pH than is should be).  
> \- “If we up the vaso anymore, we’re going to have to fight for his fingers,” Christine muttered. “and we can’t keep up the fluids like this for long – he’ll drown.” The comment about “fighting for his fingers” refers to the worrisome side effect of many powerful medications used to increase blood pressure in emergency situations – they generally work by constricting the peripheral blood vessels, in order to send all the blood to the core of the body. While this brings up blood pressure, it also stops circulation to areas such as the fingers and toes, and in extreme cases, amputation may be necessary. “He’ll drown” refers to keeping high rates of IV fluids going for a long time – the fluid can back up into the patient’s lungs.  
> \- “Bones just knew something was wrong with Spock when he was in the beginnings of pon farr……and that something just wasn’t right with Dr. Adams and Tantalus colony.” This refers to the second season episode “Amok Time” and the first season episode “Dagger of the Mind”, respectively.


	10. Chapter 10

**Summary for the Chapter:**

> McCoy is critically injured and Christine Chapel does what she does best. A character study of Leonard McCoy and a look into the world of the Enterprise medical team.

 

 

As she walked into sickbay several hours later, Christine marveled at how a good cry and a little sleep could improve one’s outlook on life.  Her internal clock had woken her up an hour before her scheduled shift as usual, only to find a message from Elise telling her, in no uncertain terms, to go back to sleep and to not even _think_ of coming to sickbay until 1400 hours.  Seeing that the same message had also been sent to Mara and M’Benga, Christine had collapsed back into bed, gratefully.  Those extra few hours of sleep, along with a hot shower and decent meal, made Christine feel like a new woman.  She strode into the ICU, ready.

 

Elise looked up from flushing the central line and smiled widely.  “Hey, honey,” she greeted.

 

“Hey, Elise,” Christine smiled, as she moved to McCoy’s left side.  “Hiya, Len,” she said softly, kissing his cheek.  “I’m stealing you back from Elise now, okay?”

 

Elise grinned.  “See, Leonard?  I _told_ you Chris couldn’t stay away.”  She dropped her voice, whispering conspiratorially, “she knows that once that beautiful child of yours gets here, she’ll have to share.”

 

“Gladly,” Christine affirmed.  She looked up to Elise.  “How’d he do?”

 

Elise smiled and motioned Christine over.  “Come see for yourself,” she said, pointing to the discontinued medication drips.  “I think he finally understands that this is supposed to be a _good_ thing.  He had three more hypotensive episodes, but responded quickly to bolusing - last one was four hours ago.  Lowest he dropped was 84 systolic and he’s been holding steady anywhere from 98 – 102 since the last episode.  Heart rate went up to 120 – 130 during the BP drops, but came right back to 80s – 90s and has been staying there.  I unhooked the vasoactives and rate controls, but they’re still primed and ready if you need them.  Dr. Sanchez d/c’d the demcorzen since he’s been a-fib-free long enough.  We dropped the sedation down 5 mikes once he started to buck the vent again two hours ago and we switched him over to CPAP then.  He’s doing well with the virdipan and vent where they are – resps are 12 – 14, sats 93 – 97%.  Oh, and that sacral redness is resolving – since he behaved himself hemodynamically, I spent extra time with the skin sealant and positioning.  There shouldn’t be a problem.”

 

Christine’s eyes ghosted over the monitors and medications, confirming Elise’s report.  Letting out a relieved breath, she gave the older nurse a quick hug.  “Thanks,” she whispered.

 

Elise shrugged gently.  “My pleasure, but he really did all the work.”

 

“Good, because I’m going to make him work even more,” Christine said firmly, directing the statement at McCoy’s lax features.  “We’ve got eight hours until Johanna gets here and she’s going to want to see those beautiful blue eyes.”

 

“Why doesn’t anyone ever tell me _my_ eyes are beautiful?” Tom lamented, walking into the room with a new bag of fluids.

 

“Tom, your eyes are beautiful,” Mara replied, coming in on Tom’s heels.

 

“Aw, Mara, I didn’t know you cared,” Tom said, pulling down the nearly empty IV fluids and replacing the line with the new bag.

 

“I don’t,” Mara admitted.  “I was just looking to shut you up.”

 

“Wow, I really feel the love here,” Tom sighed dramatically.

 

“ _I_ love you, handsome,” Elise assured him.  “Go on and get some sleep.  I’ll report off to these lovely ladies.”

 

Tom grinned.  “You’re the best, Elise.  Good day, lovely ladies,” he bowed to Chris and Mara before heading for the doors.

 

“Where’d we get that lunatic?” Mara sighed at Tom’s back.

 

“Same place we got you, sweetheart,” Elise reminded her.  Mara and Tom had attended the same nursing program and were assigned to the Enterprise within six months of each other.

 

Mara rolled her eyes as Christine laughed.  “Yeah, yeah,” Mara muttered.  Noticing the discontinued medications, she suddenly brightened.  “Good news?” she asked Elise excitedly.

 

Elise nodded and began giving the two women a full report.  She was just finishing when M’Benga walked in with Dr. Sanchez.

 

“Good afternoon, Chris, Mara,” M’Benga nodded to the nurses.  Turning to Elise, he smiled brightly.  “Michael tells me you convinced Leonard to behave today,” M’Benga said, glancing over at Sanchez.

 

“Oh, no,” Elise shook her head firmly, “I just reminded him that it would be ungentlemanly to ignore a colleague’s plan of care,” she nodded at M’Benga, “and that it would be downright foolish to ignore his _own_ ,” Elise waved the PADD with McCoy’s tri-ox notes.  Grinning slyly, she added, “I may have also mentioned that he should remember that Chris and Mara don’t make idle threats.”

 

“Damn straight,” Mara muttered.

 

Christine reddened.  “I _never_ threaten,” she insisted.  “I use evidence-based practice to firmly recommend a rational treatment plan.”

 

“Careful, Nurse Chapel, that statement sounded suspiciously Vulcan,” Jim Kirk’s voice suddenly filled the room as the ICU doors swished shut.

 

“Really, Captain?” Elise was surprised.  “I thought it sounded more like Leonard.”

 

“True,” Kirk agreed.  “Although you’d never get either of them to admit it, Bones and Spock have a lot in common around all that arguing.”  Kirk’s chuckle was abruptly cut off by a cough that attempted to hide the sudden surge of emotion he felt when he realized how much he _missed_ their sniping.

 

Noting the Captain’s tight features, Elise quickly stepped back in.  “Speaking of Mr. Spock, Captain,” she began, “when he came by early this morning, he told me not to expect you until late this evening.”

 

That worked.  Kirk grinned sheepishly, the shadows fading from his eyes.  “Yes, well, Mr. Spock doesn’t know I’m down here,” he said drily.  He _knew_ he shouldn’t have let his guard down last night.  A worried Vulcan was just as quick with a mind-meld and sleep suggestion as a worried Bones was with a sedative hypo.  One moment he was being guided tiredly into his quarters by his First Officer and the next, he woke up to find several hours had passed along with a message that Spock would be covering his shift on the Bridge. 

 

While McCoy’s sedatives knocked Kirk out longer than the pharmacokinetics dictated, Spock’s suggestions tended to only last half the time the Vulcan intended.  Bones chalked it up to the sheer strength of human emotion.  “Jim, the mind is a powerful thing – if you feel strongly enough ‘bout somethin’, all the Vulcan mind disciplines and sedatives in creation won’t make a damned bit of difference – you’re gonna wake up, blocked receptors or not.  I once had a Kirillian boy bolt awake on the operating table while I was elbow deep in his intestines….which happened to be in what would be our upper chest and shoulder…..almost knocked me clean out.  His village had been attacked by the tribe’s local rivals, and his last mem’ry before passin’ out was of his parents bein’ burned alive.  The sheer terror was enough to pull him straight out of general anesthesia.  I could’ve given that boy enough anesthesia to knock down a raging Jrszlau bull calf and it wouldn’t have done a thing.  The mind can only be quieted for so long, Jim, before even one that’s completely shut down realizes the only way to save itself is to face those demons head on.” 

 

Kirk had realized very early on that Bones was right.  In this case, not even sheer exhaustion and a Vulcan sleep suggestion could keep his mind quiet for long.  The sheer worry for his friend demanded attention, hence his presence in sickbay long before Spock had intended.  Kirk glanced around the room, challenging each member of the medical staff with his glare.

 

“Well, _I_ sure as hell won’t be the one to tell him,” Mara blurted out as Kirk’s eyes met hers.

 

The room exploded into laughter.   

 

Wiping his eyes gratefully, Kirk was the first to speak.  “So, how is he?” he finally asked, moving to McCoy’s side, eyes searching the monitors.

 

“He did well, Captain,” Elise said, giving Kirk a quick summary of what had occurred during her shift.

 

Kirk let out a relieved breath.  He looked to M’Benga.  “What’s the plan?”

 

M’Benga caught Christine’s eyes before focusing on Kirk.  “I’d like to do another EEG and cranial scan to give us a better picture of what the compound has done.”

 

Christine moved to the monitor panel and began setting up the tests.  At M’Benga’s nod, she began the EEG.

 

Kirk watched the monitor anxiously until the screen beeped and Christine pulled up the results.  M’Benga and Mara crowded around the data and Kirk’s heart soared as three smiles suddenly blossomed.  Christine started the cranial scan as M’Benga came to Kirk’s side. 

 

“The EEG shows significant improvement, Captain,” M’Benga smiled.  “The waves are still a little slow, but that could be attributed to the sedation Leonard is receiving.  The speed of the waves is much more consistent with a normal human brain and the delta and theta waves, the two waves that shouldn’t have been present last time, are no longer present.”

 

Kirk squeezed McCoy’s arm.  “That’s it, Bones,” he said softly, looking back at M’Benga as the monitor beeped again with the cranial scan results.  Christine transferred the massive amount of data onto PADDs for M’Benga, Mara, and herself to review.

 

“Michael, come take a look at this,” M’Benga called softly to Sanchez, who had melted into the background.

 

Sanchez walked over and took the PADD, letting out a surprised breath.  “Impressive,” he finally managed.

 

“Impressive?!” Mara laughed, turning her attention to McCoy’s silent face.  “Dammit Leonard, you need to wake up so someone can give these results the response they deserve!”

 

Christine nodded in mute agreement.  Mara was right.  If Leonard could see this right now, he’d be beside himself with excitement, bouncing around sickbay, pulling anyone he could find into discussion on implications and potential improvements.  She sank onto the edge of the bed and waved Kirk over to look at the PADD.  “You need to see this, Captain,” Christine said breathlessly.  She brought up the first scan, prior to their discovery of the Fabrini compound.  “This is the first scan – you see these darkened areas?” She pointed to several areas on the screen with the stylet.  “Those indicate dead tissue – there were several significant areas throughout the frontal and parietal lobes, as Dr. M’Benga had said.”  Kirk nodded as Christine moved the old scan to the left of the screen and brought up the new scan on the right.  “Now, take a look at today’s,” she said quietly.

 

Kirk gasped.  “All the dark areas are gone.  Does that mean…..”

 

Christine grinned.  “That there aren’t any dead areas in Leonard’s brain?  Yes, it does.”

 

Kirk let out a choked breath.  “It worked?” He almost couldn’t believe it.

 

A touch of clinical reserve entered Christine’s expression.  “The compound repaired the dead tissue, so that it is functioning properly physiologically,” she explained gently.  “But we can’t know how well any of Leonard’s functions were retained until he’s awake for longer periods and we can test them.”

 

Kirk nodded slowly and turned around to look at M’Benga.

 

“Christine’s right, Captain,” M’Benga said.  “The scan shows Leonard’s brain is functioning normally.  There are no dead areas – all cells are functioning properly in terms of cellular respiration.  The tissue is well-oxygenated.  It is an incredible improvement, as Christine just showed you,” M’Benga smiled.  “However, the scan simply cannot tell us whether the now healthy looking area of the frontal lobe that controls memory actually maintained Leonard’s memories, or that the language centers will connect properly with their respective structures in the body when called upon.  Looking healthy and acting healthy are two very different things in terms of brain function.  Now, Leonard showed promise when he woke up last night – as he wakes up for longer periods, as Christine said, we can test the functions of the previously damaged areas and see how well the Fabrini compound retained what had already been there.”

 

Kirk nodded, chewing the inside of his lip in thought. 

 

“The research was incredibly promising, Captain,” Christine said softly.  “The compound literally brought the cells back to their original state, so that nothing was lost.  Leonard is the first human, or even humanoid, to actually receive the compound, so we just won’t know until he shows us.  He’ll show us, though.  Can you imagine him turning up an opportunity like this?  Not only did he get to test his own tri-ox theory on himself, but he also got the chance to be the first subject to receive and expound on the effects of a potentially revolutionary cerebral compound.  He’ll be busy researching himself for months!”

 

Kirk laughed at the truthfulness of Christine’s description of McCoy.  Ever the researcher, Bones delighted in discovering new possibilities and reworking old ones.  Even under the pressure of finding cures for massive outbreaks of unknown illnesses, Bones somehow managed to retain a gentle undercurrent of pure excitement running through his red-rimmed eyes and nervous grumbling.  While the physician’s nearly limitless compassion for life often led him to throw aside self-preservation and test those new cures on himself first, Kirk had learned that he really couldn’t chew Bones out for being himself.  It was actually Christine who had finally helped Kirk understand.  After the events on Minara, Christine had pulled a pacing Jim Kirk aside in sickbay while McCoy was getting checked out.  “Captain, you are in command of the Enterprise.  You’re responsible for the actions and safety of the 430 people aboard this ship and you’ll do whatever you feel is necessary to uphold that responsibility.  If an unknown, hostile force demands to meet with you alone in order to spare the ship further damage, you go, because you take that responsibility as seriously as life itself.  Leonard may make a fuss about it because he’s worried about you, but underneath all that, he understands, because he has the same sort of responsibility.  He is CMO of the Enterprise, and his responsibility is for the health, both mental and physical, of the 430 people aboard this ship, including you.  If an untested, potential cure for an illness threatening the lives of the crew of this ship needs to be tested, he isn’t going to put anyone else at risk – he’ll test it on himself, because to cause harm to a crewmember is to have failed in his responsibility to their health.  In the case of Minara, he may _seem_ like a self-sacrificing idiot, but you were all about to do the same thing.  His sense of responsibility…..along with quick access to sedatives…. won out.  To have let either you or Mr. Spock be injured as he was, would be to have failed in his responsibility as both your CMO and your friend.  You can’t begrudge him that, Captain, anymore than he can begrudge you for throwing yourself into danger to protect the safety of the ship.”  There were very few times that James T. Kirk had been rendered speechless, but that had been one of them.  He had looked at Bones in a whole new light ever since. 

 

Kirk brought his attention back to the present.  Christine’s confidence gave _him_ confidence.  She wasn’t one to give hope lightly.  If she felt that McCoy would continue to recover, he couldn’t help but believe it too.  He smiled.  “Well, I’ll certainly know where to find him,” Kirk chuckled.  Whenever Bones was immersed in some new study, he was scarce on the Bridge, and Kirk found himself missing the presence enough to wander down to sickbay during the shift just to banter with his friend.  He’d even pretend to understand what the experiment was all about, just to see Bones light up with excitement.

 

“So, what now?” Kirk asked M’Benga.

 

M’Benga glanced back down at the PADD.  “I’d like to give one more dose of the Fabrini compound, just to make sure.  After that, we’ll let him rest and see if he can remain stable where he is.”

 

Kirk nodded.  He squeezed McCoy’s arm one more time, then stood up, stretching.  “In that case, I’ll head up to the Bridge to see how we’re progressing toward Starbase 8…. and to let everyone know how Bones is doing,” he decided.  “Call me if there’s any change.”

 

“Of course, Captain,” M’Benga assured him as Kirk left the room.

 

Elise and Dr. Sanchez retired to their quarters with well-wishes for the rest of the shift, while M’Benga conferred with Christine and Mara.

 

As Mara went to administer the last compound dose, Christine stayed behind with M’Benga.  “Any objection to another trial off the sedation?” she asked.  “I was thinking of giving him an hour or two after this dose, then as long as he stays stable, turning it off for a few minutes to give him a chance to come up on his own.”

 

M’Benga nodded.  “That’s fine,” he agreed.  “The more chances we give him off the sedation, the faster we’ll be able to get him off everything.”

 

“My thoughts exactly,” Christine affirmed.

 

“Go ahead.  Call me if you need me,” M’Benga said, heading for his office, immersing himself in the cranial scan results again.

 

McCoy received the last of the Fabrini compound without incident.  Christine and Mara took advantage of McCoy’s stable vitals and decreased medication schedule to thoroughly bathe the physician, change the bed linens and do another two rounds with the skin sealant and pillow positioning.  An hour and a half later, Mara left to assist M’Benga with two apparent cases of food poisoning, while Christine began a full set of range of motion exercises.  She was fifteen minutes into McCoy’s upper extremities when he began moving his head restlessly.

 

Christine’s eyes flicked toward the monitors, checking McCoy’s oxygenation status.  Noting that the O2 sat was normal, she switched to a full perfusion scan just to make sure the restlessness wasn’t indicative of hypoxia.  When everything checked out fine, she went over to the virdipan and shut off the sedation.  Laying a gentle hand on one arm, she spoke softly.  “It’s all right, Len, you can wake up now.”

 

After a few tries, McCoy’s eyes fluttered open.  Clouded blue shakily tracked the room as Christine tried to grab his focus.  McCoy didn’t seem to hear her though, and his respirations became faster and shallower as he continued looking for something only he knew.  He tried raising a hand to his face and upon finding himself too weak to do so, he went into full-blown panic.

 

The alarms screamed.

 

“Leonard!” Christine shouted, laying a hand on each side of his face and putting herself right in his line of vision.  “Len, look at me.  It’s Chris.  You’re okay.  You were injured and you’re in sickbay, but you’re _okay_.”

 

McCoy was still trying to raise his left arm when Mara burst into the room.

 

“We’re okay!” Christine reassured her.  “He’s disoriented.  I’m trying to get him to focus.”

 

Mara let out a nervous breath, moving to the bedside, ready to intervene if McCoy’s vitals required it, but out of the way so he wouldn’t be over-stimulated. 

 

Christine looked down at McCoy’s arm.  At her nod, Mara grasped McCoy’s hand and squeezed it reassuringly.

 

“You’re weak from being in bed, that’s why you can’t lift your hand,” Christine explained firmly, but gently, keeping her face close to McCoy’s.  “You just need to get your strength back, that’s all.  Mara’s holding your hand right now.  You feel that?”

 

McCoy’s breathing slowed slightly as he focused on Christine’s words and Mara’s grasp.  Feeling the hand in his, he closed his eyes and let out a shuddering breath. 

 

“That’s it, Len, you’re all right.  Now, open your eyes and look at me,” Christine ordered.

 

McCoy slowly opened his eyes and struggled to focus on Christine’s face.  Blinking hard, cloudy blue finally locked with Christine’s clear gaze. 

 

“Very good,” Christine smiled.  “Just breathe.  It’s all right.”  She watched as the monitors calmed down, finally blinking green as McCoy’s vitals returned to normal. 

 

McCoy’s eyes were locked on Christine’s for dear life.  Christine struggled to keep her heart from breaking at the sheer terror of disorientation in that incredibly expressive blue.

 

“It’s all right,” Christine assured McCoy again.  “Let’s start simple.  Do you know who I am?”

 

McCoy nodded slightly, his eyes never wavering from her face.

 

“Good,” Christine let out a relieved breath.  It wasn’t a verbal confirmation of orientation or memory, but they had to start small.  “Now look to your left,” she guided his face toward Mara.  “Do you remember Mara?”

 

McCoy nodded again.

 

“Good,” Christine said, bringing his gaze back to her own face.  “You were hurt when an Engineering panel exploded.  You’re in sickbay and you’re getting better.  Mara’s going to bring your hand to your face for you, and I’ll explain what you feel, okay?”

 

McCoy nodded slowly, blinking hard to maintain his focus. 

 

Mara gently brought McCoy’s hand to his face and rested it on the CPAP mask.

 

“You were having some trouble breathing,” Christine explained, “so you’re on a ventilator.  You’re breathing on your own now though, so you’re just getting oxygen and pressure to help keep you comfortable.”  There was no point in going into the minute details.  McCoy needed enough for reassurance at this point – once he was more coherent, he could demand the full story.  Too much information would only be detrimental to his disoriented mind right now.

 

Watching McCoy’s face, Christine asked, “Is there anything else you want me to explain?”  She didn’t want to freak him out with the shunt unless he needed to know right now.

 

McCoy shook his head slightly.  He was struggling to keep his eyes open.

 

Christine nodded.  “Okay.  It’s all right to go back to sleep.  You need the rest.  Someone will be here when you wake up.”

 

McCoy’s eyes finally slid shut. 

 

Christine and Mara let out a breath simultaneously as Christine reached for the virdipan and reset the sedation at the previous dose. 

 

M’Benga walked in.  “Everyone all right?” he asked calmly.

 

Christine nodded.  “He woke up disoriented, but responded to verbal reassurance.”

 

M’Benga nodded.  “Mara, could you please see to the Ensigns’ discharge instructions?  I gave them both another dose of sporsdin and they have their medications for the next three days.”

 

“No problem,” Mara acknowledged, leaving the room.

 

M’Benga turned to Christine for a full report.  “Well done,” he thanked her as she finished.  “Do you want me to inform the Captain?”

 

“That’s okay,” Christine sighed, “I’ll do it.  You know he’s going to want specifics.”

 

M’Benga gave her an understanding smile before heading back to his office.

 

****

 

The next six hours flew by for Christine.  After informing the Captain of McCoy’s second return to consciousness, she found herself explaining the details to Kirk and Spock as they came down to sickbay, as if needing to physically see their friend as they heard the information.  The word spread through the Bridge crew and Christine began passing on well-wishes and positive thoughts from the crewmembers as they called down to sickbay to let McCoy know they were thinking about him.  Uhura came by briefly to see McCoy and to let Christine know that Kirk had given her permission to leave her station if the medical staff thought music may help calm the physician in the future.

 

About an hour before the Enterprise was scheduled to reach Starbase 8, Scotty came down to let McCoy know that Johanna was on her way.  “I’ll be bringin’ yer wee one to ye soon, Doctor,” Scotty assured him.

 

Christine smiled, curious.  “If everything is actually fine with the engines, how are you planning to do all this so it doesn’t raise suspicion, Scotty?” she asked.  It wasn’t that she doubted the man - hell, Scotty was even better at technical bluffing than McCoy was at medical bluffing when the situation called for it.

 

Scotty grinned, rocking back on his heels.  “Don’t ye worry, lass,” he smiled knowingly.  “I’ve got it all worked out.”

 

“I’ve never doubted that Scotty,” Christine grinned back.

 

Before she knew it, Captain Kirk’s voice came over the comm.  “Attention all hands, this is the Captain.  We have reached Starbase 8.”

 

Kirk looked around the Bridge, pride swelling in his chest at the commitment blazing in his crew’s eyes.  An anticipatory smile curled his lips as he called down to Engineering.  “All right, Scotty.  Showtime.”

 

In sickbay, Christine squeezed McCoy’s hand and leaned down to whisper, “Here we go, Len.”

 

*****

 

Johanna McCoy paced nervously behind the pilot’s chair of the medical transport ship, _Gaila_.  They were just approaching Starbase 8, and her nerves were shot.  She was usually able to nap anywhere, thanks to her father’s influence and her current profession, but the sheer emotion of this journey made her twitchier than a cat in a roomful of rocking chairs.  She had started the trip by trying to recall everything she had learned about the woman the _Gaila_ was named for – Nyenda Gaila had been a nurse on Orion who, tired of only being able to comfort those who had loved ones ill and dying on other planets, had taken matters into her own hands and developed a system of medical transport to unite loved ones with their ill kin on other worlds.  The _Gaila_ , piloted by Dr. Mallory, a former colleague of her father’s from Atlanta General, was one of the first such medical transports commissioned on Earth. 

 

The worry had kicked in as soon as Johanna ran out of information on Gaila, so she tried to distract herself by reading over the studies Christine had sent her on the Fabrini compound, comparing it to her notes on her father’s injuries.  She lasted about two hours before the words blurred into the image of her father, pale and still on the biobed, relying on both the miracles of modern technology and relics of the past to keep him alive. 

 

That’s when she had started pacing.

 

“Miss Johanna, you’re gonna wear a rut in that floor,” Dr. Mallory sighed good-naturedly.

 

“Well, what else am I supposed to do?” Johanna grumbled.

 

“You could sit down and relax.  We’re coming up on Starbase 8 now.”

 

“Relax?!” Johanna nearly shouted.  “How the hell am I supposed to _relax_?  I don’t even know if he’s still _alive_.”  She slumped against the bulkhead as the realization of her words sunk in.  Last she had heard from the Enterprise, her father had been having trouble with his blood pressure during the first few doses of the Fabrini treatment.  What if he continued not to tolerate the procedure?  What if she was beaming over to mourn over a corpse?

 

Dr. Mallory turned in his seat.  “I’m sorry, darlin’,” he said softly.  He knew better than to try and offer platitudes.

 

Johanna’s wave both accepted the apology and dismissed the need to continue talking.  She twisted the ring on her finger gently, trying to find comfort in the only contact with her father she could have at the moment.

 

The silence continued for several more minutes, until the _Gaila_ established orbit around the starbase.  “Miss Johanna, look,” Dr. Mallory called her over to the front viewscreen.

 

Johanna pushed off the wall and leaned over the pilot’s seat.  Her breath caught in her throat as the Enterprise floated into view, a serene pearl in the darkness.  She had never seen the starship in person before, and seeing it now, she could suddenly understand her father’s tales of Captain Kirk’s love of the ship.  It was _beautiful_. 

 

“Medical Transport _Gaila_ to Starbase 8 Medical Facility,” Dr. Mallory acknowledged their arrival over the comm.

 

“Starbase 8 Medical Facility, Dr. Keary here,” came the response.

 

Dr. Mallory’s smile widened.  “Paul, how are ya?”

 

There was a brief pause, before Keary’s voice returned.  “Dan Mallory, is that you?  What’re you doing out here?  Last I heard, you were still at Atlanta Gen.”

 

“Still am,” Mallory responded, “but I do this on the side too.”

 

“Overachiever, eh?” Keary teased.

 

“Yeah, that’s me,” Mallory laughed. 

 

“So, what’ve you got?” Keary asked.

 

“I’ve got a high-profile case here.  Do you have a private channel?” Mallory winked at Johanna.

 

“Sure thing, Dan,” Keary said, giving Mallory the frequency.

 

Dr. Mallory glanced at Johanna.  “This is perfect,” he grinned.  “Me and Paul go way back, even further than me and your father.  He’ll know just what to do.”

 

Johanna grinned.  Finally, some good news.

 

“Okay, Dan, what’s going on?” Keary asked.

 

“Well, I’ve come all the way from Earth to get a young lady to her injured father on the Enterprise,” Mallory began.  “Their Chief Engineer can beam her on board from my ship, but we need a story for why I’m here.  The Enterprise is taking care of the story of why _they’re_ here,” he finished.

 

Mallory could practically hear Keary’s grin.  “Not a problem.  I keep a few ‘fake patients’ on the roster for occasions such as this.  We’ll document that one of those patient’s daughters came via the _Gaila_ , beamed directly from the ship to the medical facility, and returned the same way.  A short visit, and no reason for anyone to even think of checking the transporter log.  If they do though, my transport chief will make everything check out just fine.”

 

“Wow,” Mallory whistled, impressed.  “That is _so_ wrong,” he laughed at the obvious effort Keary had put into the deception.

 

“Yeah, but you’re going to use it, aren’t you?” Keary challenged.

 

“Hell yeah,” Mallory grinned before suddenly clamping a hand over his mouth.  He turned to Johanna.  “I’m so sorry Miss Johanna,” he apologized for the profanity.

 

Johanna snorted.  “Please, Dr. Mallory, how many times have I let loose on this trip?  My daddy may be a gentleman, but he’s also a doctor, and I’m trainin’ to be a nurse – there ain’t nothin’ I haven’t heard before.”  

 

Mallory chuckled.  “Point taken,” he acknowledged.

 

“All right, I’ve got the documentation all taken care of,” Keary came back on the comm.  “I’m transmitting the details now, so you’re all on the same page.”

 

“Thanks, Paul,” Mallory said sincerely.  “You’re the best.”

 

“Anytime,” Keary replied.  “Tell the young woman I hope for a full recovery for her father.  Oh, and do me a favor?  Ask her to give my regards to Dr. McCoy.  His neural grafting technique with the basal ganglia saved _my_ daughter’s life.”

 

Johanna choked back tears as she nodded at Dr. Mallory.

 

“I will,” Mallory said softly.  “I’m sure she’ll be glad to.  _Gaila_ out.”

 

“Dammit,” Johanna muttered, swiping at her eyes.

 

Mallory smiled gently before turning back to the console as the comm whistled again.  “Enterprise to Gaila, come in please,” Uhura’s strong voice called.

 

“Gaila, Dr. Mallory here,” Mallory responded.

 

A new voice came over the comm.  “Dr. Mallory, this is Captain Kirk.  Is everything ready on your end?”

 

“All set, Captain,” Mallory acknowledged.  “I’m a lot easier to explain than a Federation starship.”

 

Kirk chuckled.  “Yes, well, you don’t have my crew, Doctor,” he said proudly.  “Johanna, are you ready to beam over?” he asked.

 

“I’ve been ready since leavin’ Earth, Captain,” Johanna replied.

 

Kirk laughed.  “All right, get into position.  Dr. Mallory, I can’t thank you enough.”

 

Mallory waved off the thanks.  “There’s nothin’ to thank, Captain.  Len’s a damn good friend and I’d be a horse’s ass not to do everything in my power to get his little girl to him at a time like this.”

 

“Well, thank you anyway, from one friend to another,” Kirk returned.

 

“My pleasure, Captain,” Mallory said softly.  He turned to Johanna.  “Give Len a hug for me, okay?”

 

Johanna enveloped the older man in a crushing embrace.  “Thank you,” she said huskily, before taking her position again.

 

“Go save his brilliant ass,” Mallory whispered as the whine of the transporter beam took Johanna to McCoy’s side.

 

****

 

 

 

Johanna was greeted by a Scottish burr straight out of the history books.  “Welcome aboard, lassie!” Montgomery Scott grinned.  “I’m Chief Engineer Scott.  The Captain is on his way.”

 

Johanna’s face lit up as she realized who she was talking to.  “You’re Scotty?” she half-asked, half-stated.

 

“Aye, that’s me,” Scotty replied.

 

“Oh, it’s an honor t’meet you, sir,” Johanna shook his hand enthusiastically.  “My daddy’s told me so much about you.”

 

“Well now, first things first, none o’ this ‘sir’ business,” Scotty insisted.  “Just call me Scotty.”

 

“All right, Scotty,” Johanna grinned.  “I’m only in the basic courses so far, but I’d love to see what you think about using tirilium crystals to improve the reliability of life support systems.”

 

Scotty’s face brightened.  “Aye, it’d be _my_ honor, lassie,” he smiled.  “I’ve been workin’ on some modifications to the biphasic scanners in Engineering with tirilium – stuff has a lot o’ promise.”

 

Johanna was just about to launch into her idea for the crystal’s use in medicine when Captain Kirk strode into the room.  Seeing the smiles on Scotty’s and Johanna’s faces, he couldn’t help but laugh.  “Making friends already, Mr. Scott?” he asked drily.

 

Before Scotty could reply, Johanna launched herself at the Captain, hugging him tightly.  Kirk let out a surprised breath as Scotty tried desperately to hide his laughter.  Johanna stepped back unapologetically, the full intensity of her blue gaze directed right at Kirk.  He swallowed hard at the familiar force of those eyes. 

 

“My daddy’s always said he works with the best crew in the galaxy,” Johanna said firmly.  “And now I have no doubt he’s right.  I don’t know how y’all did it, but _thank you.”_

 

Kirk finally regained his voice.  “It was for Bones,” he said simply, as if no other explanation was needed.

 

Johanna smiled softly at the Captain’s nickname for her father and the tenderness there.  She turned to Scotty and gave him a hug too. 

 

“What was that for, lassie?” Scotty sputtered.

 

Johanna rolled her eyes.  “Like you had nothin’ to do with explainin’ why a Federation starship had to detour all this way,” she snorted.

 

Kirk raised his eyebrows.  “Smart girl,” he muttered.

 

“Aye, like father, like daughter,” Scotty smiled.

 

Johanna turned to Kirk.  “Captain, can you please show me to sickbay?” she asked.

 

“Of course,” Kirk motioned to the transporter room doors and led the way.

 

****

 

Christine looked up from changing McCoy’s nutrition patch to see the Captain enter the room, followed closely by Johanna McCoy.  Johanna stopped short in the doorway at the sight of her father, but visibly relaxed as she met Christine’s eyes.

 

Christine walked over to the younger woman and wrapped her in a comforting embrace.  “Hi, Jo,” she said softly.

 

“Hi, Chris,” Johanna’s muffled voice responded as she leaned into the embrace.

 

“You want me to go over everything?” Christine asked gently.

 

Johanna nodded mutely, allowing herself to be led to McCoy’s bedside.  Kirk faded back toward the doors, allowing the women time to talk.

 

Christine explained the current ventilator settings, medication regimen, and sedation plan.  She went over McCoy’s two conscious episodes and the day’s test results, before answering questions about McCoy’s earlier treatment.  Johanna’s hand went to her mouth as Christine discussed the two times McCoy crashed during the Fabrini treatment.  She sank into the bedside chair as Christine described the second arrest, but rallied enough to glare at McCoy and growl that he wasn’t even going to _think_ of arresting again now that she was there. 

 

Christine finished answering Johanna’s questions and put a gentle hand on the young woman’s shoulder.  “You want a few minutes alone with him?” she asked softly.

 

Johanna nodded, swallowing hard.  “Yes, please,” she whispered. 

 

Johanna sighed as the ICU doors swished shut.  All she could think about since learning that her father had been injured was getting to his side, and now that she was there, she didn’t know what to say.

 

She let out a breath; half-laughter and half-sob.  “Well, Daddy, you always said a little sufferin’s good for the soul, but don’t ya think this is taking it a little too far?” she choked out.  She glanced up at the monitors, reassured by the stable readings.  “You’re doin’ pretty good right now,” she said, reading the vital signs to McCoy.  She fidgeted nervously before letting out an exasperated breath.  _“This is ridiculous,”_ she thought to herself, _“he’s your father goddammit, just talk to him!”_ 

 

Johanna took a deep breath and sprang to her feet.  She leaned over and kissed McCoy’s cheek.  “Hiya, Daddy, I’m here,” she whispered in his ear.  “I’m gonna help take care of you, so just you relax and get better, ya hear?”  Smiling at the sudden feeling of normalcy, Johanna perched on the edge of the bed and took her father’s hand.  Grinning mischievously as she traced the lines on his palm, she said, “You know, you were wrong – Captain Kirk _is_ charming,” she giggled.  “Seriously, Daddy, he got me here.  I don’t know how he did it, but he did, and that makes him damn charming in my book.”

 

An hour later, Christine and the Captain came back into the room.  “I’m just going to do my assessment now, okay, Jo?” Christine said.

 

“Of course, Chris,” Johanna replied, moving off the bed.

 

“No, you’re fine there,” Christine insisted.  “Stay.”

 

Johanna nodded her thanks and resumed her place.  Kirk gestured toward the bedside chair.  “Mind if I join you?” he asked.

 

“Captain, you’re family just as much as I am,” Johanna insisted, motioning him to the chair.

 

The three sat in companionable silence for several minutes as the medical scanner whirred gently in the background. 

 

Johanna finally broke the silence.  “You know, I really wanna be mad at him,” she laughed bitterly, “for making me worry, but this could’ve happened to anyone.  It’s not like he did anything stupid,” she sighed.

 

Kirk followed Johanna’s gaze to McCoy’s face.  “Yeah,” he agreed, lost in thought.  “Not like that time he ignored the radiation leak.”

 

Johanna whirled around with enough force that she almost landed in Kirk’s lap.  “What?” she asked icily.

 

Kirk swallowed hard as his brain kicked back in.  “Uh oh,” he muttered.  “Bones didn’t tell you about that, did he?” he asked meekly.

 

“No, he didn’t,” Johanna stated firmly, “but _you will_.”

 

Christine stifled a laugh as Captain James T. Kirk, commander of the Federation’s flagship was glared into submission by yet another McCoy.

 

“Sorry, Bones,” Kirk apologized, before recalling the story.  “A little over a year ago, we were attacked by an unknown force.  One of the Engineering substations was damaged – the reactor exploded and radiation flooded the room.  Whenever that happens, the doors and vents automatically seal and can only be overridden by command code before the leak’s been resolved.  There had been an engineer in the room when the explosion occurred, so Bones went down to see what he could do.  Scotty told him about the leak and that he’d have to wait, but Bones insisted that they couldn’t wait, that if the man had received an electrical shock during the explosion….” Kirk glanced at McCoy and swallowed, “…..that he could be in cardiac arrest and that the longer they waited, the less chance he had of survival.  Well, Bones ended up overriding the door on his medical authority.  He went in, put the cardio stimulator on the engineer, gave him a dose of something, then pulled him out.  He was right – the man’s heart _had_ stopped.  Bones saved his life.”

 

Johanna closed her eyes, running her fingers over her father’s hand.  “How much radiation did he get?” she asked.

 

“Enough that he just missed throwing up on his patient before collapsing in sickbay,” Kirk remembered heavily.  “He spent a few hours throwing up and getting fluids before the radiation treatment finally kicked in.  There wasn’t any lasting damage.”  Kirk looked at his friend fondly.  “You know what he said to me when I asked him why he did such a stupid thing?” he asked Johanna.

 

Johanna shook her head.  “No, but I can imagine,” she said softly.

 

Kirk kept his gaze on McCoy’s face.  “He said, ‘Dammit, Jim, I’m a doctor.  First do no harm.  If I had waited, that boy’d be dead.  A sin of omission is a sin just the same.  If I’d just stood there waitin’ for that leak to resolve, I’d be just as responsible for his death as that explosion.  We can treat low-level radiation poisoning.  We can’t treat death.’”

 

Johanna sighed.  “Yep, that’s my daddy,” she said, her voice torn between sadness and pride.

 

McCoy moved his head slightly as the doors swished open and Spock walked in. 

 

Johanna looked to Christine, who began adjusting the sedation.

 

“Ah, Mr. Spock,” Kirk greeted the Vulcan.  “May I present Johanna McCoy?”

 

Spock inclined his head in acknowledgment.  “Indeed.  It is a pleasure to meet you Miss McCoy.”

 

“Johanna, please,” Johanna insisted.

 

“Very well, Johanna,” Spock said.  He met Christine’s eyes.  “I was coming to inquire as to the doctor’s health.”

 

Christine smiled.  “I think he’s getting ready to wake up again,” she said, nodding to McCoy as he restlessly tossed his head again.  “I’ve just turned off the sedation.  I’m going to call Dr. M’Benga, but you can all talk to him in the meantime.”

 

Johanna kept a firm grip on McCoy’s hand, while resting her free palm along her father’s cheek.  “Daddy?” she asked nervously.

 

“Bones,” Kirk said softly, gripping McCoy’s arm.

 

Spock rested a hand gently on the physician’s shoulder.

 

“Come on, Daddy, you have no idea how much Georgia misses those eyes,” Johanna half-sobbed.  She _still_ had McCoy’s former patients come up to her and tell her that it was those compassionate blue eyes that kept them fighting at Atlanta General.  “C’mon, Daddy, wake up for me,” she pleaded.

 

M’Benga entered the room silently, taking a place at the foot of the bed, nodding quietly to Christine.

 

A soft groan made its way through the ventilator mask as McCoy’s eyes fluttered open.  Christine took an involuntary step forward as cloudy blue began slowly tracking the room.  McCoy’s chest heaved, just as Johanna threw herself around his neck.

 

Bringing her head back up, Johanna put herself right in McCoy’s line of vision.  “Daddy,” she breathed out.  “Daddy, it’s Jo.  Look at me,” she said clearly, keeping her eyes locked on her father’s. 

 

McCoy’s eyes slowly met Johanna’s, sliding into focus.  He squinted, a slight frown evident under the mask.

 

“It’s okay, Daddy, I’m here,” Johanna said.

 

McCoy’s eyebrow went up in confusion as he shook his head slightly.

 

“I’m really here, Daddy,” Johanna tried to make him understand.  “I’m with you on the Enterprise.  ‘Come hell or high water’ right?  Well, here I am,” she smiled, leaning down to kiss his cheek.

 

McCoy blinked hard.  Focusing again on Johanna, his eyes narrowed slightly and his mouth twitched into a weak imitation of his disbelieving ‘yeah, right’ expression.  His eyes slowly left Johanna’s face and sought out Christine, Spock, and Kirk.

 

“She’s really here, Bones,” Kirk assured McCoy as the physician’s eyes met his.

 

“Indeed, Doctor.  Johanna is here on the Enterprise,” Spock said.

 

McCoy’s eyebrow went up again, as if surprised that Spock was sharing his delusion.

 

“It’s okay, Daddy,” Johanna said softly, “I’m not sure I’d believe me either.”

 

McCoy’s lips twitched in a half-approximation of a smile.

 

“Believe what you need to believe, Len,” Christine said gently, “but just know that Johanna’s here and she’ll be here when you wake up again.”

 

McCoy’s eyes closed slowly, a slight smile on his face.

 

Spock clasped his hands behind his back.  “I do not believe Dr. McCoy thought Johanna was real,” he stated quietly.

 

“Well, I’m gonna sit right here until he _does_ ,” Johanna growled.  Kissing her father’s hand, she stretched out alongside McCoy, nestling her head against his chest.  “He only gets to think I’m a hallucination once,” she declared.  “Next time he wakes up, he’s gonna remember why momma always called me _his_ child.”

 

Spock’s eyebrow approached his hairline.  “Indeed,” he said, “it will be impossible to ignore such a force.”

 

Kirk stifled a laugh.

 

Johanna simply smiled. 


	11. Chapter 11

**Summary for the Chapter:**

> McCoy is critically injured and Christine Chapel does what she does best. A character study of Leonard McCoy and a look into the world of the Enterprise medical team.

 

 

Johanna woke up several hours later with a stiff neck and the vivid memory of familiar singing.  Reveling in the echo of the dream, Johanna allowed her mind to slowly take in the waking world – the quiet beep of the medical monitors, the hiss of a hypospray, the steady rise and fall of her father’s chest and……singing?

 

Johanna resisted the urge to sit up and rub her eyes, focusing instead on the voices.  A strong, soulful woman’s voice sang an achingly familiar melody in a foreign language.  A few bars later, an earthy tenor tentatively began to harmonize, growing stronger as the accent lost itself in yet another strange tongue.  As the tenor quietly dropped off, the woman’s voice continued alone, moving seamlessly into English.

 

“Summertime and the living is easy……fish are jumping and the cotton is high….”

 

Tears sprang to Johanna’s eyes.  She struggled to remain still, swallowing hard against the sudden sob lodged in her throat.

 

“….one of these mornings, you’re going to wake up singing…..then you’ll spread your wings and take to the sky…..but ‘til that moment, there’s a’nothing can harm you….with daddy and mamma standing by…..”

 

Tears were streaming down Johanna’s face as the sob finally broke free.  She buried herself further into her father’s chest as a surprised Scottish burr asked, “Johanna?  Are ye all right lass?”

 

Johanna pulled herself upright with shaking arms, sniffling loudly, not even bothering to try and wipe away the tears coursing down her cheeks.  “That song….” she choked out.  “How do ya’ll know that song?”

 

Scotty looked to Uhura. 

 

“The computer suggested it when I was looking for old-Earth songs,” Uhura explained gently.  “It sounded like something Dr. McCoy might know.  I was hoping it would comfort him.  I’m sorry if it upset you, sugar.”

 

Johanna shook her head vehemently.  “No,” she insisted, “it was beautiful.  What languages were you both singing?”

 

“Swahili,” Uhura said quietly.

 

“As fer me, ‘twas an old dialect of Scots,” Scotty said.  His face suddenly twisted into an apologetic cringe.  “I’m sorry ye had to hear my so-called singin’,” he sighed, “I just couldnae resist joinin’ in.”

 

Johanna laughed around another sob.  “Daddy used to sing me that song every night when I was little.  It was my first memory of him and he’d always swear he was sorry for makin’ my first memory one of his awful singin’!”  Johanna laughed again around her tears, her voice growing stronger as memory won out over current fears.  “An’ I always told him that I didn’t want a singer’s voice, I wanted my _daddy’s_ voice.  Whenever he sang that song, it just made everythin’ all right.”  Johanna’s eyes drifted in memory as she smiled fondly at McCoy through her tears.  “My second month in nursin’ school, I had such an awful day……I saw a young momma bleed out in front of me.  After talkin’ about what happened and the mechanics of _why_ it happened, I brought up suggestions for helpin’ treat arterial ruptures in the future and my instructor wouldn’t listen to _any_ of them.  She said my ideas were ridiculous and that we could only work with what we had.  I told her I was taught different and when she said that whoever taught me was an idiot, I guess I’d kinda had enough.  I yelled that she had obviously never met my daddy and if she ever did, he’d teach _her_ a thing or two.  Then I ran out of the hospital.”  Johanna chuckled bitterly.  “I thought for sure that there was gonna be my last day of nursing school.  I ran home and left a message for Daddy.  My momma helped – Daddy always said she could hug the rain out of a stormy day and leave nothin’ but the sun - but I knew Daddy would _get_ it – he’d rant about it with me, then help me figure out how to make it better.  Turns out he listened to my message right before a badly injured landing party beamed back up.  You know what he did?  He called me back from the operatin’ room in between patients.  He told me everythin’ was gonna be all right, that we’d talk about it, but that what I really needed now was to rest…..and he sang me that song as the staff was triaging and figurin’ out who to bring him next.” Johanna smiled, running her fingers lightly across her father’s arm.  “An’ it worked.  I fell asleep and when we talked later, after he had taken care of everyone…well, everythin’ was all right.”

 

Johanna looked up to find Scotty suspiciously moist-eyed.  Uhura swiped lightly at her eyes.

 

“What the hell is this?” Mara’s voice boomed as she came back into the room.  “I leave you guys alone for five minutes and everyone ends up crying?!”  She walked to the bedside and double-checked the monitors and machines.  The alarms would have sounded if something serious had happened, but alarms _had_ been known to fail.  Satisfied that McCoy was still physically stable, Mara met Johanna’s eyes.  “Everything okay, kiddo?” she asked quietly.

 

Johanna nodded.

 

“Good,” Mara blew out a breath.  “Because I sure as hell don’t want Leonard thinking we made his daughter cry while he was unconscious.”

 

Uhura rolled her eyes.  “You’re not _that_ horrible, sugar,” she chuckled.

 

“Damn, guess I have to try harder,” Mara muttered.

 

Johanna ducked her head as she snorted back a laugh. 

 

Mara grinned at Johanna’s smile.  “Well, my work here is done,” she said, pleased with herself.

 

“Aye,” Scotty smiled appreciatively.

 

Johanna looked back up.  “Mara, do you know what the plan is for today?” she asked.

 

Mara stifled a yawn.  She and Chris were sharing the shift again, swapping brief nap periods.  Even though McCoy was stable enough that he didn’t require two nurses at this point, they continued dividing his care, both too committed to the treatment at this stage to leave, while Elise, Tom, and Jack helped cover the main sickbay shift.  Christine was due back in a few minutes.  Clearing her head, Mara nodded at Johanna.  “Yeah, I’m pretty sure Chris wants to kick some ass today,” she grinned.

 

Johanna’s eyes brightened.

 

“I heard her talking to Dr. M’Benga about getting rid of the sedation and trying him off the ventilator completely today,” Mara continued.  “He’s stable enough now that it’s time for him to really wake up so we can see what’s going on.”

 

“Agreed,” James Kirk’s voice filled the room as the ICU doors swished shut behind him and Spock.

 

Mara rolled her eyes.  Sometimes she swore the room was bugged.  News was notorious for traveling fast on a starship, but there were times, like this, when people knew things before the thought was even finished coming from the source’s mouth.  It could be downright ridiculous sometimes.  “Good morning, sir,” she finally directed at Kirk.

 

“Morning, Mara,” Kirk returned, before taking a seat next to Johanna.  “You doing okay?” he asked quietly.

 

Johanna nodded, smiling at Uhura and Scotty.  “Yes, Captain, thank you,” she replied.

 

“Please, Johanna, it’s Jim,” Kirk said.

 

Johanna frowned.  “Sir, you’re the Captain of the Enterprise….it’s just not proper to call you by your first name,” Johanna insisted.  She had been raised to be respectful of everyone, especially her elders.  Even when her father’s colleagues, who had known her since she was born, insisted on her calling them by their first names when she saw them at the hospital, or around town, Johanna just couldn’t break the habit of using their title. 

 

Johanna watched as Spock’s eyebrow went up and he gave an almost imperceptible nod.  Kirk turned and shot the Vulcan a look, as if to say ‘don’t tell me I have to deal with this again – it took long enough to convince _you_ otherwise.’

 

Kirk sighed.  He took Johanna’s hands in his own, squeezing gently.  His eyes met hers and Johanna was surprised at the intensity there.  “Johanna,” Kirk started.  “When I’m on the Bridge, when the ship is in danger and some alien race we’ve never met before is demanding to speak to the leader of this vessel, I’m the Captain.  But when I’m in here, in sickbay…..when I’m with Bones……I’m Jim.  There’s a difference…..and if this is about respect…. well, I ask you to respect _that_.”

 

Johanna swallowed at the emotion in Kirk’s face.  “All right, Jim,” she said softly.  Kirk let out a relieved breath and let go of her hands.  Johanna’s eyes twinkled.  “But if Daddy hears me callin’ you Jim, I’m gonna tell him what you just said,” she grinned.

 

“Understood,” Kirk chuckled.  He glanced up as the doors opened and Christine and M’Benga walked in.

 

Christine glanced around the room, immediately noting the dried tear tracks on Johanna’s cheeks.  She caught Johanna’s eyes and gently nodded the younger woman to the corner by the door.

 

“I’m okay, Chris,” Johanna assured Christine before the nurse even had a chance to ask.

 

“You sure?” Christine asked, eyes narrowed slightly in a combination of disbelief and concern.

 

“Well, as fine as I _can_ be with all this goin’ on,” Johanna clarified, glancing back at her father’s still form.  She looked at Christine again.  “Miss Uhura and Mr. Scott were singin’ a song that reminded me of when I was a little girl.  I started telling stories and got a little emotional, that’s all.”

 

Christine nodded, understanding.  “All right,” she said quietly, squeezing Johanna’s arm gently before walking with her to the bedside.

 

“Mornin’ Len,” Christine greeted McCoy with her customary kiss.  “Time to wake up,” she said softly, turning off the sedation and standing by the ventilator as M’Benga explained the plan to everyone.

 

“Well, I’ll just be wishin’ the Doctor good luck then,” Scotty said, standing up to leave.

 

“You don’t have to leave, Scotty,” Kirk assured the Engineer.

 

“Aye, but too many faces could be a mite overwhelmin’,” Scotty said simply.

 

Christine smiled at his thoughtfulness.

 

Uhura kissed her fingers and laid them gently on McCoy’s hand.  Catching Christine’s eyes, she nodded at the promise of a full report later before taking Scotty’s outstretched arm and leaving the room.

 

“Does anyone have any questions?” M’Benga asked Johanna, Kirk, and Spock.

 

Johanna shook her head, scooting closer to McCoy’s side.

 

M’Benga nodded at Christine.  She turned off the ventilator and leaned over to remove the mask. 

 

“Sat’s holding at 97%, resps 16,” Mara reported.

 

McCoy groaned softly, his head lolling to the left.

 

“Daddy?” Johanna called.  “Daddy, it’s Jo.  Open your eyes,” she said firmly.

 

With a heavy sigh, McCoy’s eyes fluttered open, locking onto Johanna.  His eyebrow quirked as she smiled at him.  “Yep, I’m still here,” Johanna grinned.

 

McCoy cocked his head slightly, his gaze never wavering.  He drew in a breath, coughed, and tried again.  Successfully managing a deep breath, his tongue darted across dry lips and he opened his mouth.

 

Nothing happened.

 

McCoy frowned, eyes narrowing in concentration.  He tried again.

 

Nothing.

 

Christine watched McCoy’s respirations increase as his mind struggled through the problem.  He attempted to raise a hand to Johanna’s face, but only succeeded in moving his arm a few millimeters off the bed before it fell back to the mattress heavily.

 

“Daddy?” Johanna asked nervously.  She looked to Christine.  “What’s wrong?” she demanded.

 

Christine stepped forward, waiting for the scream of the alarms.  Waiting for the panic.

 

It never came.

 

McCoy’s eyes dulled.  They swept the room once, lingering for a moment on Johanna’s worried face, then closed heavily.

 

“Daddy?” Johanna’s voice rose as she shook McCoy.  “Daddy, wake up,” she half-sobbed.  When he didn’t respond, she whirled on Christine.  “What’s going on?” she asked hopelessly, tears streaming down her face.

 

Christine swallowed hard.  “He’s giving up,” she said, not believing the words even as they came from her mouth. 

 

“What?!” Johanna cried.  “Why?!”

 

“He was unable to speak, or move well,” M’Benga spoke up quietly.  “I believe, in that moment of despair, that Leonard refused to believe _any_ of it, including us, was real.  He won’t respond because he’s shielding himself from that pain, in a sort of self-imposed unconsciousness.”

 

“Oh no you don’t,” Johanna growled through her tears, throwing herself across McCoy’s chest.  “Don’t you _dare_ try and hide on me.”

 

Kirk finally managed to speak.  “What can we do?”

 

Spock stepped forward quietly, clasping his hands behind his back.  “Doctor, if I may….” he began.

 

M’Benga nodded, gesturing for Spock to continue.

 

“A mind meld may prove beneficial in returning Doctor McCoy’s mind to a conscious state,” Spock said.

 

Johanna lifted her head. 

 

Kirk frowned.  “Bones isn’t fond of mind melds when he’s conscious and healthy, Spock,” he pointed out quietly.  “Do you really think it’s wise to attempt one now?”

 

Spock sighed heavily.  “I do not wish to attempt a meld without first obtaining the Doctor’s permission,” he admitted, “but, in this case, there is an 80.62% chance I will be successful, thus making it the only logical option left.  If I can make contact with McCoy’s mind, I can assist him in understanding what is real and what is not.”

 

Christine’s eyes flickered from McCoy’s face to Spock’s.  “And you’d be able to talk to Leonard if his language abilities were functional in any other way,” she said slowly.

 

“Correct,” Spock acknowledged.  “If Doctor McCoy’s difficulty lies in translating language from thought to action, we would be able to converse unimpeded in his mind.”

 

Johanna bit her lower lip nervously before straightening with the assurance of decision.  “Do it,” she said to Spock.  “If he can talk to you, he can help explain what’s wrong.”  She locked eyes with Spock.  “You be his voice, Mr. Spock,” she said firmly.  “Tell us what’s wrong so we can fix it.”

 

Christine nodded as M’Benga caught her gaze.  “The scanners can’t tell us anything at this point,” she pointed out, “so getting Len to tell us what’s wrong is our best bet.  Who better to diagnose him than himself?”

 

M’Benga glanced at Kirk, who nodded his agreement.  “Go find him, Spock,” he said quietly.

 

“Please proceed when you are ready, Mr. Spock,” M’Benga said.

 

Johanna watched as Spock leaned over McCoy, lightly mapping out the contact points on the physician’s face.

 

Fingers in place, Spock pressed down.

 

 The ICU disappeared.

 

****

 

“Doctor.”  Spock’s voice resonated through the darkness. 

 

Silence.

 

“Doctor McCoy.”  The darkness was unsettling.  Spock had melded with McCoy before, and he _never_ had to search for the physician’s essence.  McCoy’s mind was usually, quite literally, illuminating.  McCoy’s sheer passion for life was a supernova, blinding light and searing heat, as native to each of his cells as the finely honed organelles and just as vital.  The darkness from which supernovas were born rippled just under the surface, the gentle rush of waves on a primordial lake, equal parts sorrow, comfort, and prescription.  It was McCoy’s humanity that always kept Spock from reeling – that gently powerful, earthy humanity tempered the heat of the supernova, found understanding and acceptance of the darkness, and left McCoy’s mind a brightly lit place of passion, brilliance, attentiveness and, even in the midst of the human’s staggering capacity for illogic…..peace.  Vulcan’s wise sun and Georgia’s fresh breeze.

 

As the seconds passed, Spock felt the subtle thrill of fear in his chest.  He knew that only 20.4 seconds had passed since he first entered McCoy’s mind, but he also knew _McCoy_.  The darkness was wrong and as much as McCoy grumbled about “damn Vulcans messin’ around in each other’s heads”, the physician respected the practice, saw its therapeutic values, and most importantly, always responded to Spock during a meld. 

 

Spock acknowledged the fear for what it was – a strong emotion and a valid one, but not conducive to the task at hand.  He recognized its existence with Amanda’s humanity and dismissed it with Sarek’s logic.  It was illogical to deny the feeling, for it did _exist_ , but it was equally illogical to let such a thing reduce his efficiency.  He could not afford distractions – he needed to find McCoy.

 

Spock began probing deeper in a careful balance - pushing against the darkness while respecting the physician’s innate privacy.

 

16.8 seconds later, he felt McCoy go rigid under his fingertips.

 

“Doctor McCoy!” Spock shouted over the sudden flood of panic in McCoy’s mind.  “Doctor, it is Spock,” he stated firmly, hoping the familiar name would bring the physician past the surge of emotion.

 

McCoy fought harder.

 

****

 

The alarms screamed.

 

“What’s he doin’?!” Johanna yelled, lurching across the bed to push Spock away.

 

Kirk grabbed Johanna’s arms, holding her back.  “No, Johanna, don’t!” he shouted breathlessly.

 

“Get your damn hands off me,” Johanna growled, tearing herself out of Kirk’s grasp, sprawling across McCoy’s chest.

 

****

 

Spock frowned as a split-second image of a bearded Vulcan flashed through McCoy’s jumbled mind at his words.  Bringing all his focus onto that moment, Spock realized that he was looking at a remarkably similar version of himself – one with facial hair, a cold stare…… and the ability to strike fear into Leonard McCoy’s heart.   

 

The mirror universe.  There was only one thing a barbaric version of himself could have done to elicit such terror from McCoy….. and rightly so – how the physician had managed to hide such a violation, Spock couldn’t even begin to understand.  Pushing through a surge of nausea, Spock grabbed the image of the mirror Spock as it flew by again on a dangerous current of fear.  Tucking the memory aside, Spock focused all his attention on projecting an image of his true self to McCoy’s fracturing mind.

 

****

 

Johanna lunged for Spock again as McCoy began shaking, gasping for air.

 

M’Benga stepped forward from his place across the bed.  “Johanna, you cannot terminate a Vulcan mind meld,” he said firmly, forcing himself to keep the alarm at her attempts to separate Spock and McCoy from his voice.

 

“The hell I can’t!” Johanna countered.

 

“Johanna, let me finish,” M’Benga kept his voice firm, but calm.  “It is dangerous for both parties if their minds are separated before they are ready.  The initial contact can be a shock.  I’m certain Mr. Spock is reassuring Leonard that he is only there to assist in his recovery.”

 

“I don’t care if Mr. Spock’s got the healing hands of the good Lord himself,” Johanna’s angry shout faltered as a sob lodged in her throat.  “I’m not gonna sit here and watch him hurt my daddy,” she choked.

 

****

 

“Doctor McCoy, it is Spock,” Spock repeated, replacing the fear-tinged image of his mirror universe counterpart with a neutral image of himself on the Bridge at his station.  “I am not here to harm you.”

 

A flash of uncertainty overrode the fear, before McCoy succumbed to the terror again.  Latching onto that moment, Spock gently began adding images of time he and McCoy had spent together – triumphant success in the medical labs as they found a cure for a virulent new strain of Rigellian fever, hour-long philosophical debates on the Bridge subsequently ended by Uhura’s sighing laughter telling them to take their arguments elsewhere, quiet evenings of chess and drinks with Jim where McCoy began to make Jim think he was drunker than the Captain really was while Spock certainly didn’t play along, but also failed to correct McCoy’s obvious exaggerations.

 

****

 

McCoy let out a shuddering breath and his body went limp as the violent shaking dissipated into subtle trembling.  Johanna felt her heart stop as an agonizing ten seconds passed before McCoy took in another breath.  Her heart stuttering in her chest, Johanna reached for Spock again.

 

Christine slid smoothly onto the bed next to Johanna.  She shot a quick ‘don’t interfere’ glare to everyone else in the room and Kirk watched, fascinated, as Christine’s eyes immediately softened.  She turned to face Johanna, stooping slightly to meet the young woman’s eyes, matching her position to Johanna’s – one hip against McCoy’s trembling form, her knees turned inward, lightly brushing Johanna’s.  “Jo,” Christine said quietly.  Kirk watched as Johanna focused on that one, soft syllable, filled with emotions he couldn’t even name, and moved out of the chaos and into Christine’s understanding.

 

Meeting Johanna’s eyes, Christine took the young woman’s hands gently and began absently running her thumb over the backs, as Johanna had done for McCoy.  “Give him time,” Christine murmured reassuringly, her hands continuing to anchor Johanna, her eyes never wavering from the familiar, panicked blue.  No one else existed in that moment.  “Leonard may hate this, but he trusts Spock.  Spock would never harm him and he knows it.”

 

“But…..” Johanna croaked, leaning into her father a little more.

 

“But, he’s freaked out,’ Christine filled in, her voice never wavering from its low, soothing tone.  “His brain’s muddled from prolonged unconsciousness, he probably still thinks you’re a hallucination, and now he’s got another voice in his head.  Give him time.  Spock will help him understand.”

 

“But if……” Johanna started again, weakly.

 

“But if Spock can’t help Leonard understand, he’ll leave – a meld may be the most logical option at this point, but Spock respects Leonard too much to follow logic alone.  If continuing will put Leonard at greater risk or if Leonard tells him to get out, he’ll get out.”  Johanna drew in a breath, but before she could even ask, Christine’s voice changed almost imperceptibly.  The low, soothing tone hardened ever so slightly – a hard winter frost hidden by the softness of a shining sun.  Christine’s compassionate eyes allowed just a hint of dangerous promise.  Dropping her voice so only Johanna could hear, Christine spoke.  “And if he didn’t,” she flicked her eyes briefly toward Spock, “I would take him down.  Regardless of how I feel about him.  If he hurt Len, I’d take him _down_.”

 

Johanna nodded slowly.  She felt no fear at Christine’s calm, matter-of-fact promise.  Johanna had no doubt that if Spock were to put McCoy in danger, that Christine would use any physical or chemical means necessary to stop him…..and that she would succeed.  She would assault the Vulcan she loved with her heart to protect the man she loved with her whole being.  Johanna didn’t even know why the doubt had crossed her mind - her father always spoke of Spock with a strong undercurrent of respect.  She chalked it up to protectiveness and worried nerves, but Johanna still found herself letting out a breath, both relieved at the confirmation of an ally and touched by the devotion there.

 

The sun overtook the frost as Christine’s voice resumed its soothing tone and her eyes softened, the innate healer’s nature shining through.  “We won’t have to though,” she said with a knowing smile, “because it’ll never happen.”  Christine squeezed Johanna’s hands firmly and nodded at McCoy.

 

Johanna suddenly became aware of the room again as she pulled her eyes from Christine.  The room was silent except for the steady beep of stable vital signs.  McCoy’s chest rose and fell evenly, all traces of respiratory distress and tremors gone. 

 

“See?” Christine smiled.  “You’d never know it listening to them argue, but they _do_ actually listen to each other.”

 

Johanna snorted back a laugh, swiping furiously at her running nose as the laughter threatened to dissolve into tears again.

 

****

 

Spock felt McCoy’s mind ease as the positive images took hold.  “Doctor, it is Spock,” he repeated clearly, reinforcing the reassuring memories.  “I _will not_ harm you,” he stated firmly.  “I am here to assist you, but if you find my presence….unsettling…..I will leave.  If you believe I may cause you harm, ask me to leave and I shall comply.  I am not here to _take_ ……only to _give,_ should you desire it.”

 

A flicker of light touched the darkness – a tentative candle in an overwhelming storm.  “Spock?” McCoy’s voice ventured shakily.

 

“Yes, Doctor, I am here,” Spock replied.  “No harm will come to you in this place.”

 

The candle faded away as McCoy’s mind lightened softly.  Spock was reminded of McCoy’s standard migraine adjuvant for Jim – “lights, 25%” would always precede the hypo, and Jim always swore the eerie “not quite light, not quite dark” lighting helped immeasurably.  The tentativeness of the low lighting was still unnerving, but quite logical, from what Spock had seen.  Even a full-blooded Vulcan would fight a familiar friend’s meld after being subjected to such violation.

 

It was difficult to explain what occurred during a mind meld.  Those who had not experienced the joining of minds could not truly understand how the participants both “saw” and “didn’t see” each other in physical form, how they spoke without speaking and heard even the smallest vocal inflection without hearing.  So, when Spock heard McCoy’s shattered voice and saw his dull eyes in that “not quite light, not quite dark”, it was difficult to explain the concern that surged through him from what, according to neurology, he actually “didn’t see” and “didn’t hear.”

 

“Spock, that really you?” McCoy’s small, unsure voice barely rose above the darkness.  He let out a breath; half-laughter and half-resignation.  “As if my hallucination’d tell me that he wasn’t real,” McCoy chided himself.  “Well, you might as well stick around – beats talkin’ to myself, even though that prob’ly exactly what I’m doin’,” McCoy muttered tonelessly.

 

“Doctor McCoy, you may not believe your senses at this moment, but I can assure you that I am substantial, that I am _real_ ,” Spock stated.

 

“Sure you are,” McCoy sighed.  He took a step forward and Spock was hit with the full measure of the physician’s despair as dull eyes closed in a lifeless face.  McCoy scrubbed his hands across his face, his voice muffled by his palms.  “I’m not gonna argue the point Spock,” he sighed.  “I’ve gotta hell of a headache – seems appropriate that losin’ your mind would hurt like hell, doesn’t it?”

 

“Doctor, I am not here to add to your deluded manner of thought.  You will cease this illogical fallacy immediately – we have work to do,” Spock said firmly.

 

“Illogical fallacy?!” McCoy’s voice rose familiarly, “Why you green-blooded……nothing makes a damned bit of sense.…..it’s like I’m tryin’ to talk but nothin’s comin’ out……I can’t move, I can’t _think_ straight,” McCoy growled that last bit, dropping his hands to his sides helplessly, “…..I’m even thinkin’ Jo’s on the Enterprise,” he laughed bitterly at that before bringing challenging eyes up to Spock, “and now I’ve got _you_ , in all your _logical_ glory, insisting that I repent my evil human ways, throw away my quite _warranted_ emotion, and listen to whatever wisdom you’ve come to impart.”  McCoy sighed heavily and it was the sound of a man with nothing left.  “Well, Mr. Spock,” he drawled tiredly, “you sure as hell ain’t no angel, so take your sermon to another of God’s creatures, ‘cause I’m _tiahd_.”  Spock could barely make out the last word through the thick Georgian drawl as McCoy sank to the floor, as if the admission alone sapped all the energy from his body.

 

Spock clasped his hands behind his back, drawing in a breath to continue the argument.  As he had suspected, the insult had succeeded in drawing McCoy out, but it wasn’t enough – the physician was withdrawing again.  The lights had flashed to 50%, but immediately darkened again at McCoy’s resigned exhaustion.  McCoy was on the floor, slumped over drawn-up knees, as if by making himself as small as possible, he could avoid the pain surrounding him.  Spock was suddenly reminded of Lt. Rivers, a security officer who had lost his fiancé on Viridian III.  Spock had been with Jim when the Captain informed the lieutenant, recovering from a concussion in sickbay, that Lt. Karsters had been killed on the planet.  Rivers refused to believe the Captain’s report, throwing himself off the bed despite McCoy’s vocalization of alarm, and stumbling to one of the darkened ICU rooms, throwing up violently before collapsing against the wall and sliding to the floor, adopting the position McCoy was currently in.  McCoy had followed Rivers silently.  Without a word, the physician had entered the dark room, covered the vomit with a towel, then sank to the floor directly across from the sobbing lieutenant, leaving only millimeters between them.  The two men were mirror images, but where Rivers was hugging his knees, face buried, closed off, McCoy was cross-legged, gently watching the top of Rivers’ head, completely open.  When Rivers had finally looked up, McCoy was ready, not insisting on anything, simply present.  The lieutenant threw himself into that openness, pouring out his grief, and McCoy, never leaving the moment, silently waved Kirk and Spock away, knowing they had been hovering at the door without even turning around.

 

Spock let his hands drop to his side before striding over to McCoy.  Drawing on the memory, he sank gracefully to the floor, mirroring McCoy’s cross-legged, open posture with Lt. Rivers.  He moved forward 1.3 millimeters, so that his shin just barely touched McCoy’s foot.

 

McCoy’s head jerked up at the contact and he found himself staring into Spock’s calm, dark eyes. 

 

“Doctor, what is the neurological effect of a six minute anoxic episode?” Spock asked.

 

McCoy’s eyes narrowed as confusion twisted his features.  “What?” he half-laughed at the utter randomness of the question.

 

“When a human brain is deprived of oxygen for six minutes, what effect does it have on cognitive function?” Spock repeated as calmly as if they were in the lab together, working on an experiment.

 

McCoy’s eyes remained narrowed in a mix of ‘what are you up to?’ and ‘what did I miss?’, but his face smoothed out as he reached for something he was sure of.  “Well, supposin’ someone _lived_ through that kinda oxygen deprivation, they could end up with all _kinds_ of cognitive dysfunction – memory loss, speech impairment…..”

 

“Could they also experience confusion, altered thought processes?” Spock interrupted.

 

“Well, yeah, sure,” McCoy confirmed, “’specially if they were in and out of consciousness – that’ll really mess with a man’s perception of time and reality.  Again, though, you’re supposin’ that someone actually _survived_ that long of an anoxic episode, and with enough non-infarcted tissue that they could think at _all_ ,” McCoy reminded him.

 

“You have,” Spock stated simply.

 

McCoy shook his head.  “What _are_ you goin’ on about?” he sighed, frustrated.

 

“ _You_ survived a six minute anoxic episode, Doctor.  Your current belief that you are ‘losing your mind’ is a culmination of the natural cognitive effects of such an episode, as you just dictated.”  Spock leaned forward slightly, demanding McCoy’s full attention.

 

McCoy’s eyes widened.  “I survived…..” he began, letting out a disbelieving breath, before pulling his thoughts into some semblance of order.  “How in blazes did I do _that_?” he demanded, curiosity and disbelief overtaking the previous lifelessness in his eyes.

 

“Through a combination of regeneration, reperfusion, and other treatments,” Spock replied.

 

“ _What_ other treatments, Spock?” McCoy persisted.

 

Spock sighed.  “I am unable to provide the minute medical details you require, Doctor,” he reminded McCoy.

 

McCoy leaned forward.  “Spock,” he said quietly, “if I got myself into that kinda trouble…. _six minutes_ …..then there’s no way on God’s green earth we should be havin’ a conversation right now.  Cerebral regen is iffy at best, and even if it _did_ work reliably on tissue outside the brain stem, it wouldn’t leave the old pathways intact – everything would be new, so the fact that we’re talkin’ and I know who the hell you _are_ , just isn’t right accordin’ to the medicine _I_ know.” 

 

Spock nodded.  “You are correct, Doctor, in that cerebral regeneration alone would not have worked.  However, you do indeed have great knowledge of the medicine that _did_ work – in fact, your theories were the basis for your treatment.”

 

McCoy growled at the pause.  “For heaven’s sake, Spock, spit it out,” he gestured impatiently.

 

Spock allowed the barest hint of a smile to touch his lips.  McCoy’s mind was brightening as his true essence came back out.  Lights 60%.  “Nurse Chapel insisted on using the tri-ox theory you based on Dr. Kerebus’ article.  Your tri-ox notes were used along with a Fabrini compound, previously untested in humanoids, which restored your cerebral cells to their previous state.”

 

McCoy’s eyes grew wider.  “The one they couldn’t get past the blood-brain barrier?” he asked.

 

Surprise flitted across Spock’s face.  “Yes,” he replied.  “You know of it?”

 

McCoy nodded.  “Of course – you think I wouldn’t dive into all that data?  I’ve _still_ got studies lined up for some of their research.  We just finished readjusting the molecular structure of the Kirillian flu vaccine based on the Fabrini’s experiments – broadened the covered spectrum to damn near every strain imaginable, and even engineered it to cover strains we don’t know about yet,” McCoy said proudly, before his gaze turned inward again.  “So for Geoff and Chris to get it to work, along with the tri-ox……” McCoy bit his lower lip as he ran the possibilities through his head, before suddenly brightening and grabbing Spock’s arm.  “They did it, didn’t they?  A cerebral shunt!”

 

Spock struggled to keep his smile in check.  Lights 90%.  “Indeed, Doctor, they did.”

 

McCoy jumped to his feet, grinning wildly……and the supernova returned.  Even Vulcan eye physiology couldn’t keep Spock from blinking as the brilliant light of McCoy’s true essence flooded his mind.  “I _knew_ it would work!” McCoy whooped as he began pacing, running ideas for future treatment implications out loud.  He stopped for a moment and shook his head apologetically.  “Poor Geoff, he must have _hated_ havin’ to put in such an archaic piece of equipment,” he half-laughed, before bouncing high on his toes and grinning at Spock.  “Just think of the potential, Spock!” McCoy’s eyes were dancing as he reached up for his head to feel the shunt.

 

“You will not be able to feel it here, Doctor,” Spock explained.

 

McCoy finally stopped pacing.  “Whaddya mean, _here_?” he asked, frowning as he looked around, seemingly for the first time.  “Come to think of it, where _is_ here, anyway?”

 

“Our minds are one,” Spock said simply.

 

McCoy froze.  Fear ghosted across his features briefly, before he met Spock’s eyes and regained his composure, nodding his understanding.

 

“Doctor, if you find my presence unsettling….” Spock began.

 

McCoy shook his head.  “Spock, this whole damn _process_ is unsettling,” he grumbled.  “But _your presence_ isn’t.  You just surprised me, is all.”  McCoy chuckled, trying to lighten the mood.  “Don’t they teach you fellas how to knock?”

 

“Knock, Doctor?” Spock queried.

 

“You know, before strollin’ into someone’s head,” McCoy clarified.

 

“You were unresponsive, Doctor…..I was unable to obtain your permission before seeking you out, but if you wish……” Spock explained.

 

McCoy shook his head, laughing.  “It’s okay, Spock,” he reassured the Vulcan.  “It was a joke.  Forget it.”

 

Spock frowned and drew in a breath to speak again, but McCoy cut him off.  “Don’t,” McCoy’s voice was hard.

 

Spock sighed as McCoy realized that he had discovered the real reason for the physician’s fear.  “Doctor, what my counterpart did….” he began.

 

“I said, _don’t_ ,” McCoy growled icily.

 

“Doctor, my counterpart’s intrusion….” Spock tried again.

 

“Dammit, Spock, what part of _‘don’t’_ do you not understand?!” McCoy exploded.  “And _stop_ calling him your counterpart – he wasn’t anythin’ like you.  You think I wouldn’t have kicked your sorry ass outta my head if I thought otherwise?”

 

Spock took a deep breath and let it out slowly.  “Doc-“ he swallowed and softened his voice.  “Leonard,” he said gently, the name unsure on his tongue.  It was the right choice though – McCoy had calmed down in sheer surprise at the use of his given name, and was focused, somewhat warily, but openly, on Spock.  “What he did was an abomination according to my people – a violation of the greatest magnitude.  In Surak’s time, such violations, as rare as they were, were punishable by death.  I am in great admiration of your strength, Doctor.  Vulcans who have been subjected to forced mind melds have gone insane.  Many have died under the strain of even the healer’s meld.  I have never heard of a Vulcan, let alone a human, surviving such a violation, especially without treatment, with their sanity intact.  The fact that you have not ‘kicked my sorry ass out of your head’ is most impressive.  There is no reason to be ashamed of your fear – indeed, it is most logical in this situation.”

 

McCoy’s eyebrow went up and a half-smile touched his pale face.  “Why, Spock, are you callin’ _me_ logical for havin’ a strong emotional reaction?” 

 

“In this situation,” Spock clarified firmly.

 

McCoy laughed, and the darkness passed.  “Noted, Mr. Spock,” he chuckled.

 

Spock’s eyes danced.

 

McCoy sat down again.  “Well, then, Spock, you said yourself this isn’t a social call,” he gestured around the empty space.  “What’s goin’ on?”

 

Spock sobered.  “Doctor, are you certain…..”

 

McCoy held up a hand, interrupting him.  “I’m all right, Spock,” he said quietly.  “Thank you……what you said helped……and heaven forbid there should be a next time……well, I’ll know to go to you first.”

 

Spock nodded.  “There will not be a next time,” he said simply, but McCoy knew the Vulcan well enough to hear the icy, protective promise there.  Spock met McCoy’s eyes quietly.  “And I welcome your presence in my quarters, should you ever desire to discuss the matter,” he offered.

 

McCoy accepted the offer with a gracious nod, swallowing hard past the lump in his throat.  “Thanks, Spock,” he managed.  Clearing his throat, he straightened.  “So, what brings you to my highly illogical, highly emotional little mind?” he asked drily.

 

Spock nodded, moving to the matter at hand.  “When you last regained consciousness, you appeared to have difficulty speaking and regulating basic movements.  I suggested to Dr. M’Benga that a mind-meld may be beneficial in determining the reason for the dysfunction.”

 

McCoy chuckled.  “So basically, ya’ll were hopin’ I’d really be in here, so you and I could figure this out from the inside?” he summarized.

 

“I believe I just said that, Doctor,” Spock replied, one raised eyebrow the only indication of his amusement.

 

“Of course you did, Mr. Spock,” McCoy placated him with a soft laugh.  He drew in a breath.  “All right, then, tell me exactly what I was doin’ – my mind’s so muddled right now, I don’t trust what’s rattlin’ around in there.”

 

Spock proceeded to describe McCoy’s weak movements and failed attempts at speech in detail.

 

“Wait a minute, Jo’s really here?!” McCoy burst out, as Spock described his attempt at saying his daughter’s name.

 

“Indeed, she is,” Spock confirmed, before adding, drily, “and she is quite offended by your continued insistence that she is not real.”

 

“Yeah, I’ll bet she is,” McCoy agreed, “and I’m sure I’m gonna get an earful ‘bout it, so hurry up!”

 

Spock’s eyebrows shot up in surprise.  “You _wish_ to hear Johanna yell at you?” he asked, confused.

 

McCoy’s eyes softened.  “Spock, she’s my little girl.  If she needs to vent some worry first, dammit, she can yell at me all she likes, so long as I get to hold her while she’s doin’ it.  I don’t get to see her damn near enough.”

 

Spock nodded.  “An admirable quality in a father,” he said quietly.

 

It was McCoy’s turn to raise an eyebrow.  “Careful, Spock, that’s _two_ compliments now,” McCoy teased.  “I may start thinkin’ I’m hallucinating again.”

 

“In that case, Doctor, I shall endeavor to refrain from acknowledging the _very few_ positive qualities you possess,” Spock replied.

 

McCoy grinned.  “That’s more like it,” he said.  “Now, shut up and give me a summary of that last cranial scan.”

 

Spock chose to ignore pointing out the fact that he could not both “shut up” and inform the doctor of the test results at the same time.  He recited the scan summary Dr. M’Benga had given him.

 

McCoy nodded thoughtfully, gaze turned inward as if mentally testing his own synapses.  His eyes narrowed in concentration as he brought a hand to his face, worrying his lower lip.  1.9 minutes later, he looked back up at Spock.  “Basal ganglia problem is most likely – it’s got enough circuits to explain the movement issues, and the speech deficit too.  If I’m understandin’ enough to respond to basic commands and we’re having a coherent conversation here, it’s probably more a Broca’s aphasia….not a classic case, but it makes sense with the frontal lobe damage.  There were probably a few pathways that got trampled in all the excitement.  Geoff’s gonna have to go in to remove the shunt anyway – tell him to look at the basal ganglia and follow the axonal pathways, especially to Broca’s.  He can just re-graft the broken ones.”

 

“Understood,” Spock acknowledged, standing up slowly.

 

McCoy frowned.  “How long you been in here?” he asked suddenly.

 

Spock tilted his head, as if he didn’t understand.

 

“Dammit, Spock,” McCoy growled.  “Don’t give me that look.  I know there are limits to how long is safe for these damn melds, and I’d bet real money you should’ve left a long time ago.  There’s probably a shorter time limit for melding with injured minds too, isn’t there?” 

 

Spock opened his mouth to speak, but McCoy cut him off, with a shake of his head. 

 

“Never mind – don’t answer that,” McCoy grumbled, already knowing the answer.  He glared at Spock.  “Well, go on, get out of here.  Go tell Geoff that I’ll owe him the next few neurosurgeries.”  He let out a long-suffering sigh.  “I swear, I’m out of it for a little while and ya’ll turn into reckless fools – well, more’n usual.”  He stared at Spock, who was watching him, with an amused glint in his eyes.  “What’re you still doin’ here?  Scat!  Tell M’Benga to get in there and sort out those pathways.  Jo’s waiting and _someone’s_ gotta keep you and Jim in line.”

 

Spock allowed the amusement to creep into his lips.  “Of course, Doctor,” he nodded.

 

McCoy smiled softly.  “Thanks for coming for me, Spock,” he said sincerely.

 

“You have done the same for me,” Spock said simply, before gently separating their minds and stepping back into the ICU.

 

****

 

Spock straightened slowly, reeling from the sudden influx of outside stimuli.  Kirk was at his side in an instant, guiding the Vulcan to a chair, one hand on Spock’s elbow, both steadying him physically, and grounding him mentally.  Spock nodded gratefully.

 

“You all right?” Jim asked softly.

 

“I am unharmed, Captain,” Spock reported. 

 

Kirk nodded, squeezing Spock’s shoulder.  He fidgeted nervously before finally asking, in a low voice pitched only for Vulcan hearing, “Bones?”

 

“Quite himself,” Spock replied drily.

 

Kirk snorted back a relieved laugh.  “You were in there so long, I wasn’t sure if…..” he trailed off.

 

“The doctor had shielded himself quite deeply,” Spock explained.  “It took some time to find his essence and convince him of the reality of his conscious episodes.”  He kept the issue of the mirror universe to himself – at this time, there was no reason to involve Jim and since discovering the issue, Spock felt almost exceedingly protective of McCoy’s mind and privacy.

 

Kirk chewed the inside of his cheek, worried.  “But he came around, right?”

 

“Indeed, and he provided a diagnosis,” Spock said.

 

Kirk brightened.  “What do we need to do?” he asked breathlessly.

 

“What you _need_ to do is _share_ all this with the rest of us,” Johanna demanded, glaring at Kirk and Spock.

 

Kirk flushed.  “I’m sorry, Johanna,” he apologized, embarrassed. 

 

Johanna waved away the apology.  “Don’t apologize,” she insisted.  “Just talk.”

 

Mara snorted and Christine grinned as Kirk shut up and let Spock relate his conversation with McCoy.

 

The tension melted from Johanna’s body as Spock confirmed that her father’s personality was intact and that he finally understood that she was really on the Enterprise.  Upon hearing that McCoy was expecting her shouting, Johanna grinned.  “Damn right I’m gonna yell at him,” she growled, but there was no menace to it.  “Especially about that radiation bit,” she narrowed her eyes at Kirk, who sighed heavily at getting his friend into trouble.

 

Spock turned his attention to M’Benga as he outlined McCoy’s assessment of the data.  M’Benga smiled as Spock related McCoy’s future surgical promise.  “That would be most appreciated,” M’Benga chuckled.  “Leonard is the neurosurgeon, not I.”

 

“For someone who’s not a neurosurgeon, you’re sure doing a hell of a job,” Johanna pointed out.

 

M’Benga acknowledged the compliment with a soft smile.

 

Christine and Mara were sharing a knowing look.  Johanna turned to the two women.  “What?” she asked, curious.

 

Christine laughed.  “It just figures we’d end up using Len’s basal ganglia grafting technique too,” she smiled, shaking her head.  “He’s practically got himself to thank for his whole treatment plan.”

 

Johanna shook her head furiously.  “Don’t even _think_ of sellin’ yourselves short,” she practically shouted, jumping up from the bed.  “I’ll be the first to say my daddy’s brilliant, but he’s gettin’ better because of all of you.”  She pointed at Kirk.  “You kept going, even when everythin’ said he didn’t have a chance in hell of makin’ any sort of meaningful recovery, and not because you couldn’t let go, but because you knew there was still a chance out there, somewhere, and you waited, because you knew _they’d_ find it,” Johanna nodded at the rest of the room.  “And you got me here,” she continued, fiercely passionate blue locking onto Kirk’s surprised hazel.  “You got me to my daddy’s side, where I belong, and you gave me the chance to be with him, whatever happened.  Maybe Miss Uhura knows a language than can properly express what that means to me, because English sure doesn’t have the words.”

 

Johanna turned to Spock.  “Your devotion to my daddy and the Captain is just……again, I don’t even have the words.  Mr. Scott told me that _you_ were the one to enable the Captain to get me here – we’d never even met, but you treated me as family, just as much as ya’ll obviously treat each other.  And you just went into daddy’s _mind_ for heaven’s sake – and now we know what the scanners can’t tell us and we’ve got a plan to bring him back all the way.  Don’t think I don’t know how highly personal Vulcan mind melds are and I know you were in there longer than you should’ve been.  I don’t know what was goin’ on, but I know now, without a doubt, that you were there for my daddy, when none of us could be, and all I can say is thank you.”

 

Johanna faced M’Benga, Mara, and Christine.  “And you three,” she sighed.  “I could never hope to find a team like ya’ll to work with.  I know you’ve been on constant shifts since Daddy was injured and ya’ll’ve done it all – from emergency procedures, to surgery, to experimental medication schedules, to workin’ with hundreds year old equipment, to believin’ in daddy’s research while doin’ your own and creatin’ hope from a situation that never should’ve had it in the first place.  Ya’ll are brilliant, but you also never forgot who was in that bed, and you managed to keep daddy as part of the team, even as he insisted on bein’ the most critical patient on board.  Then _I_ got here and you took care of me too.”

 

Johanna swallowed hard before meeting Christine’s eyes.  “Chris, I can only _hope_ to be a fraction of the nurse you are.  You believe in Daddy……you kept his blood circulating, you talked to him, shouted at him when he was bein’ an idiot, and consulted with him on his own treatment even when it looked like he had no chance, because you knew, if the situation was reversed, he’d do nothin’ less for his patient.” 

 

The room was silent.

 

“Shit,” Mara finally muttered, swiping at her eyes.

 

Scattered laughter eased the high emotion.

 

Johanna grinned as she pushed back her own tears.  “Well, what’re ya’ll waitin’ for?” she demanded, glancing at McCoy.  “He told us what to do, so let’s do it!”

 

Kirk laughed and looked at M’Benga, Mara, and Christine.  “Well, you heard the young lady,” he chuckled. 

 

“I’ll go prep surgery,” Mara grinned, her step light as she left the ICU.

 

****

 

Three hours later, Mara and Christine were settling McCoy back into the room, beginning the standard post-operative routines.  M’Benga sat down with Kirk, Spock, and Johanna.

 

“Leonard did very well,” M’Benga smiled.  “There were indeed several damaged pathways that required re-grafting.  He tolerated the re-grafting and the shunt removal without incident.”

 

“For once,” Mara muttered under her breath, wincing as Christine playfully kicked her. 

 

“I decided the leave the central line in for now,” M’Benga continued.  “I do not forsee any further complications, but I would rather have the access if we need it.”

 

“Leave it in,” Johanna nodded.  “The whole point of emergencies is that they _aren’t_ foreseen.”

 

“Agreed,” M’Benga replied.  “We can remove the line at the bedside when Leonard is ready.”

 

“Thank you,” Johanna whispered, surprising M’Benga with a tight embrace.

 

“My pleasure,” M’Benga said softly.

 

Johanna returned to her place at her father’s side, perched on the edge of the bed, gently stroking his hand.  Kirk and Spock took up residence on McCoy’s right, standing just out of the way, allowing Mara and Christine room to work.

 

Half an hour later, McCoy began to stir.

 

“Daddy?” Johanna asked breathlessly, squeezing McCoy’s hand.  “C’mon Daddy, open your eyes.”

 

McCoy groaned softly.

 

Kirk stepped forward, squeezing McCoy’s left forearm.  “Bones,” he said; a quiet plea.

 

“C’mon Daddy, I was savin’ the yellin’ for later, but so help me, you _know_ I’ll start now if I have to,” Johanna threatened.

 

McCoy swallowed thickly as his eyes fluttered open.

 

“Daddy?  Look at me,” Johanna said firmly.

 

McCoy blinked heavily and brought a slow hand to his eyes.

 

“Lights, 25%,” Christine ordered the computer.

 

McCoy swallowed again as Johanna gently took his hand away from his eyes and held it close to her face.  “C’mon Daddy, over here,” Johanna insisted.

 

McCoy forced his eyes in the direction of the familiar voice.  Blinking rapidly, tired blue eyes fought past the remnants of anesthesia and focused on their mirror image.  A weak smile lit his face.  “Hiya, sweetheart,” he croaked.

 

Johanna clutched McCoy’s hand to her lips, tears spilling down her cheeks as she released a relieved half-sob, half-laugh.  “Hiya, Daddy,” she smiled through her breaking voice.

 

McCoy struggled to bring Johanna back into focus.  “’M s’ry thought you were halluc’nation,” he slurred.

 

Johanna laughed as the tears fell faster.  Kissing his hand again she assured him, “It’s all right, Daddy, I think I can forgive you this time.”

 

“Good,” McCoy murmured, blinking hard to force his eyes back open.  “J’m, Sp’ck, you here?” he asked thickly.

 

“Yes, Bones,” Jim struggled to keep his own voice from cracking.  He squeezed McCoy’s arm again to let him know where they were.

 

McCoy slowly turned his head to the right, groaning at the movement.

 

“Headache?” Christine asked softly, leaning in so McCoy could hear her.

 

McCoy groaned again as he nodded.

 

“Well, don’t do that,” Christine laughed quietly, gently placing her hands alongside McCoy’s face to stop him from moving his head.  “I’ll get you something for the pain.”

 

Even through the lingering anesthesia, the emotion in McCoy’s eyes was enough to make Christine gasp.  “Th’nks,” he slurred.

 

Christine squeezed his shoulder in reply and excused herself to the medication tray.

 

McCoy opened his eyes gingerly to find Jim, Spock, Mara, and M’Benga looking down at him.  He managed to rally enough energy to raise a surprised eyebrow and demand, “What’re ya’ll starin’ at _me_ foah?”

 

Kirk grinned at the thick Georgian accent.  He may have had a hell of a time understanding Bones on the rare occasions when his accent flared, but just hearing his friend’s voice again was enough to make his heart swell.  “We’ll tell you about it sometime, Bones,” he laughed.

 

Christine returned with the hypo, gently administering the dose to McCoy’s jugular.  A minute later, some of the tension melted from McCoy’s face and he sighed.

 

“Better?” Christine asked.

 

“Yeah, thanks Chris,” McCoy whispered, closing his eyes.

 

“Go back to sleep, Daddy,” Johanna said softly.  “You still gotta get rid of the rest of that anesthesia.”

 

McCoy shifted his eyes to his daughter.

 

Johanna understood the look there.  “We’ll be here when you wake up,” she assured him, kissing his hand again.

 

McCoy shifted his eyes back to Kirk and Spock, as if seeking their confirmation as well.

 

“Sleep, Bones,” Jim ordered McCoy gently.  Eyes dancing, he added, “come back when you’re more coherent.”

 

McCoy’s eyes narrowed slightly as he muttered something under his breath.

 

Johanna snorted.

 

“Do I want to know?” Kirk asked.

 

“I do believe the word was ‘smartass,’” Spock offered.

 

McCoy attempted to glare at Spock through half-closed lids.  “Want all th’ details,” he insisted weakly.

 

Christine grinned.  “Oh, you’ll get them, Len,” she assured him.  “Now, get some sleep. You’ll need the rest for all the energy you’re going to expend reading your chart.”

 

“Yeah, and _we’re_ gonna need the rest to have the energy to deal with him bouncing around sickbay,” Mara muttered, eyes sparkling.

 

Christine laughed as McCoy’s eyes closed and his breathing evened out into the steady rhythm of comfortable sleep.  Mara was absolutely right……and Christine couldn’t _wait_ to be surrounded by that familiar excited energy again.

 

M’Benga nodded to the room and headed for the doors as Johanna nestled alongside McCoy and began softly singing.

 

“Summertime….and the livin’ is easy…..”  

**Notes for the Chapter:**

> Medical Notes:
> 
> \- “Aphasia” is dysfunction in the expression or understanding of language. Broca’s area is a part of the brain involved in language ability. As usual, this story is based on fact, with future possibilities inferred from current knowledge. Basic information on aphasia can be found at [ http://www.nidcd.nih.gov/health/voice/aphasia.htm]  
> \- According to Memory Alpha, “by 2253, McCoy had developed a surgical procedure for the humanoid brain; grafting neural tissue to the cerebral cortex, followed by the creation of an axonal pathway between the tissue graft and the basal ganglia.” This was apparently used by the EMH in the Voyager episode “Lifesigns.” [ http://memory-alpha.org/en/wiki/Leonard_McCoy]  
> \- Source material used to create future understanding of the role of the basal ganglia was found here: [ http://www.nlm.nih.gov/medlineplus/ency/article/001069.htm] and here: [ http://brainlang.georgetown.edu/PUBS/Ullman_Cortex_06.pdf]  
> \- The song Uhura, Scotty and Johanna sing is “Summertime”, composed by George Gershwin for 1936’s “Porgy and Bess.” Full lyrics can be found here: [ http://www.stlyrics.com/songs/g/georgegershwin8836/summertime299720.html ]. I was looking for Southern songs and I could just hear McCoy singing this to his infant daughter, but changing the line “your daddy’s rich and your momma’s good lookin’” to “your daddy may not be rich, but your momma’s sure good lookin’.”


	12. Chapter 12

**Summary for the Chapter:**

> McCoy is critically injured and Christine Chapel does what she does best. A character study of Leonard McCoy and a look into the world of the Enterprise medical team.

 

 

Johanna bolted awake at the sound of retching.  Throwing her legs over the side of the bedside cot, she thrust it back to make room before hurrying to McCoy’s side.  Mara was already there, linking one arm under McCoy’s armpit and dragging him upright while simultaneously thrusting a basin in front of him with her free hand. 

 

“What can I do, Mara?” Johanna asked, grabbing McCoy’s other arm to help keep him upright.

 

“There’s a red button alongside the bed frame, just under the monitors,” Mara nodded toward Johanna’s side of the bed.  She hitched McCoy further up with a grunt as the physician heaved again.

 

Johanna held the button down with her free hand, wincing as McCoy shuddered against her supportive arm.  “How far?” she asked Mara, as the head of the bed came up.

 

“Full 90 degrees,” Mara ordered before turning her attention back to McCoy.  “Easy, Leonard,” she said softly.

 

The bed locked at 90 degrees with a soft click.  McCoy, now fully upright, groaned painfully and vomited more bile.

 

With McCoy sitting up and at less risk for aspiration, Mara let go of his arm and glanced at Johanna.  “Can you hold this?” she asked quickly, nodding to the basin.

 

Johanna swallowed hard, wincing as McCoy heaved violently again.  _“Dammit, Jo, this is not the time,” she_ growled to herself as her own stomach began to protest.  She had never been good with emesis – as soon as a patient started heaving, Johanna would start right along with them.  It was damn embarrassing.  Blood, urine, feces, nasopharyngeal suctioning, hell, even gastric suctioning, she was fine with, but she just couldn’t handle emesis. 

 

Mara caught the subtle paling of Johanna’s features and nodded understandingly at the forceful swallowing.  “I’ve got him – go grab Tom for me,” she gestured toward the doors.

 

“Dammit, Mara, if I’m gonna be a nurse, I can’t exactly _avoid_ these situations,” Johanna growled angrily, reaching for the basin.  “Go get what you need.”

 

“Look, Johanna, at the risk of sounding like a complete ass, I _really_ can’t afford another sick McCoy right now,” Mara said firmly.

 

Johanna’s features hardened with familiar resolve as McCoy vomited again.  Keeping one hand on her father’s arm to steady him, she grabbed the basin with her free hand.  “Go get what you need,” she repeated, her voice even.  “The longer we wait, the longer we have even _one_ sick McCoy, and I’m not havin’ my daddy sufferin’ any longer ‘cause of my stupid phobia,” Johanna insisted.

 

“’S not stupid,” McCoy gasped, closed eyes squeezing tighter as another spasm hit.

 

“Shut up, Daddy,” Johanna ordered.

 

McCoy choked on another groan as he heaved again.

 

Mara stood up just as the ICU doors opened and Christine came in for shift report.  Taking one look around the room, Christine met Mara’s eyes, nodding in silent understanding.  She moved swiftly over to the medication tray, setting up analgesic and antiemetic hypos.  Striding to McCoy’s bedside, she handed the hypos to Mara before gently putting a hand on Johanna’s shoulder.  “Jo, do me a favor and grab me a bottle of saline and a cup from the cabinet behind my desk,” Christine asked softly.

 

Johanna shot Christine a glare as Mara administered the antiemetic with a soft hiss.  “Chris, I can _handle_ it,” she insisted.

 

“You _are_ handling it,” Christine pointed out, “but Len is going to need a mouth rinse to deal with all that acidity.”

 

“You’re not just findin’ me somethin’ to do to make sure I don’t end up needin’ an antiemetic too?” Johanna narrowed her eyes at Christine.

 

“Dammit Johanna, there’s a time and a place for stubborn pride and this ain’t it!  You think I wouldn’t tell you if I were kicking you out?” Mara was losing patience, fast.

 

Johanna considered that silently for a moment before rising with a nod and heading for the doors.

 

Christine sighed, turning her attention to McCoy.  “How’s the nausea, Len?” she asked, squeezing his shoulder gently.

 

“Comin’ down,” McCoy whispered, attempting slow, deep breaths, eyes clamped shut, perspiration beading along his pale face.

 

“Headache again?” Christine asked, frowning at the deep lines around his eyes.

 

“Yeah,” McCoy acknowledged, catching himself mid-nod with a strangled groan.

 

Christine held up a hand as Mara went to inject the analgesic.  “You ever had nausea with acetodone before?” she inquired curiously.

 

McCoy shook his head, choking back a cry.  “Dammit,” he gasped.  “Not acetodone, but once with ibutodone,” he finally managed.

 

Christine hurried to the medication tray, grabbing another hypo and returning to McCoy’s side.  “All right, how about trying a different class then, just in case that last med contributed to the nausea?  10 of napromorphone?” she checked with him.

 

“Go ahead,” McCoy agreed, bringing his hands to his face, gingerly seeking pressure points to help get the pain under control.

 

The hypo hissed as Christine slowly lowered the head of the bed to 45 degrees and instructed the computer to dim the lights further.  Mara took the basin and headed for the sink in the back corner to rinse it out. 

 

“Which came first?” Christine asked softly once the medications kicked in and McCoy began to relax.

 

“Headache must’ve gotten bad enough to wake me up,” McCoy murmured, a hand still over his eyes.  “Then I moved and the nausea kicked in.”

 

“Coming down?” Christine looked for verification.

 

“Yeah,” McCoy slurred tiredly.  He cracked one eye open and focused on Christine.  “Thanks,” he said sincerely.

 

“Anytime,” Christine gave his hand a squeeze.  “That head of yours has been through a lot lately – I’m not surprised it’s complaining.”

 

“Yeah,” McCoy coughed weakly, moving the hand from his eyes to finger the shunt removal site.  An eyebrow went up as he felt hair around the light bandaging.

 

Christine grinned.  “Hey, I _told_ you, remember?  I believe my exact words were ‘as soon as that shunt comes out, you’re getting a follicular regen.’”

 

McCoy frowned.  “I don’t remember,” he murmured, meeting Christine’s eyes worriedly.

 

Something in McCoy’s expression made Christine pause.  She tucked the strange feeling aside before lightly teasing, “Well, I think unconsciousness is a pretty good excuse for not remembering _everything_ I say.”

 

McCoy’s frown deepened as he shook his head gingerly, worrying his lower lip.  “I don’t remember that,” he insisted, seemingly more to himself than to anyone else.

 

Christine’s eyes widened as that strange feeling tentatively offered understanding.  “Len?” she asked softly, laying a gentle hand on his forearm. 

 

McCoy was silent as he slowly met Christine’s eyes.

 

Christine swallowed, hard.  As good as she was at therapeutic conversation, as much as she had augmented her psychological training since being assigned to the Enterprise……if this was what she thought it was…….and with McCoy…..

 

“You said you don’t remember _that_ ,” she reiterated quietly, watching confusion, worry, and sheer McCoy reluctance warring for control of his expression as he quickly looked away.

 

“No, not….I mean….” McCoy’s face crumpled as his scattered thoughts betrayed him.

 

Christine sighed inwardly as she watched him simultaneously attempt to piece together a response to her statement and figure out how to avoid acknowledging the slip entirely.  It was probably only due to sheer trauma and medication-enhanced exhaustion that she was even getting a _glimpse_ of this and, knowing McCoy, she had a very narrow window of time to get any further before the  “I’m fine” part of his healer’s personality resurfaced.  Gently squeezing McCoy’s arm to redirect his attention, Christine asked softly, “What do you remember?”

 

McCoy swallowed nervously and looked down at his hands.  “Chris, I….” he rasped, weakly clearing his throat, “I….I don’t know….” He punctuated that last word with a frustrated grimace.

 

“You _do_ know, you’re just not _sure_ ,” Christine clarified gently.  “And that’s okay.”

 

McCoy shook his head tiredly.

 

“Doctor,” Christine allowed a touch of firm professionalism to edge her voice, a subtle reminder to McCoy of his title and role.  “What do you remember?” she asked again.

 

McCoy looked up slowly, exhausted reluctance mixed with ‘dammit, I know I’ve got to get this over with’ lining his features.  He drew in a shaky breath as the ICU doors swished open and Johanna came back in.

 

_“Son of a BITCH,”_ Christine growled to herself.  They were so CLOSE.  Christine saw Mara step forward purposefully from where she had been waiting back by the sink.  The red-haired nurse met Christine’s frustrated eyes with a nod toward Johanna - a silent offer.  Christine shook her head with a rueful smile, grateful for the chance, but understanding that the moment was lost.  Interrupted interventions were nothing new to her – already internally wording her recommendation to M’Benga, she gave McCoy’s arm a final, reassuring squeeze as she turned to Johanna and changed gears.  Christine smiled brightly at Johanna as she handed over the saline rinse.  “Thanks, Jo,” she said, pouring a small amount into the cup.  Mara came over and handed her the clean basin.  “Okay, Len, swish and spit, you know the routine,” Christine passed him the cup, gently stabilizing the bottom.  After two rinses, Christine took the cup and basin to the sink.  Mara followed quietly, leaving Johanna at McCoy’s side.

 

“How ya doin’ Daddy?” Johanna asked nervously, reaching for McCoy’s hand.

 

“Fine, darlin’,” McCoy replied, squeezing Johanna’s hand lightly.

 

Christine sighed, meeting Mara’s knowing gaze.  There it was – Leonard “I’m fine, let’s take care of _you_ ” McCoy was back.  If Christine wasn’t so used to seeing it, the sudden transition would have been jarring.  Just moments ago, McCoy had been an exhausted, confused, slightly terrified, recovering brain injury patient, on the verge of acknowledging a very likely near-death or out-of-body experience.  Yet, as soon as Johanna walked into the room, his face suddenly cleared of everything but a hint of exhaustion - he sat up a bit straighter, his posture radiating open compassion.

 

“You know, it still freaks me out how well he does that,” Mara murmured, picking up on Christine’s train of thought.

 

Christine nodded absent-mindedly.  Getting Leonard McCoy to admit to being anything other than “fine” was generally a feat in itself.  The man was so committed to his profession and the well-being of others, that he never considered himself a priority.  From neglecting to put himself on the rest rotation in emergency situations to forgetting to treat the bullet wound in his own arm, McCoy naturally took himself out of the equation to focus on others.  It was simply part of his healer’s personality…one that could be somewhat infuriating in its innocence…..yet one that Christine Chapel had become quite proficient in dealing with in her time as Head Nurse of the Enterprise.

 

From the first time she treated an unconscious, dehydrated McCoy after he neglected to take time to eat, drink, or rest during a three-day medical emergency, Christine had found herself naturally stepping into the worrisome vacancy of “McCoy wrangler.”  She had learned early on that McCoy’s boundless compassion tended to crowd out any idea of self-preservation or self-care, not for any desire to punish himself, but for simple lack of even _thinking_ about it.  Christine had somehow intuitively understood that sensitive soul and she noted that while McCoy certainly didn’t lack friends who cared about him – Kirk and Spock could almost out-mother hen McCoy when the physician was in need – the subtleties that McCoy seemed to effortlessly note in Kirk, Spock, and other crewmembers that spoke of a need for treatment or conversation, were often missed by others in McCoy himself.  Christine remembered McCoy returning from Tyree’s planet, oblivious to the bullet wound in his arm in his concern for the Captain’s emotional state – Christine had had to restrain herself from reading Kirk the riot act after she found out that he had never even realized McCoy had been shot.  After Minara, it was Christine who picked up on McCoy’s unhealed psychological wounds – and whether it was gently suggesting Kirk or Spock talk with him, or demonstrating her own fair skill in psychology, Christine became the go-to person for getting McCoy to psychoanalyze himself as well as he did the rest of the crew.  McCoy had quickly learned that Christine wouldn’t allow him to wave off concern, and he came to appreciate the quiet support, along with Christine’s rather liberal interpretation of “physician heal thyself” as more of a “so help me, you WILL take care of yourself, whether _you_ do it or we do it _for_ you.”  As much as Kirk and Spock cared for McCoy, they could often still be placated by McCoy’s insistence that he was fine.  Christine had no problem politely telling him that he was full of crap when he refused to admit he _wasn’t_ fine.  She had mistakenly thought she was the only one – until she focused back in on Johanna.    

  

“Liar,” Johanna muttered, swallowing back a sudden, threatening sob.

 

Christine felt a small smile edge its way past the surge of emotion at Johanna’s voice.  She should have known Johanna wouldn’t put up with anything less than McCoy’s own insistence in truthfulness from a patient. 

 

“Jo…..” McCoy started.

 

“Don’t you ‘Jo’ me,” Johanna growled through her half-sob.  “If you think I’m gonna let you lie to me after scarin’ me like that…..”

 

McCoy cringed and lowered his eyes.  “I’m sor-” he started.

 

Johanna yanked her hand from McCoy’s grasp and pointed a surprisingly steady finger at her father.  “No apologies,” she interrupted.  “Just answer the question – and none of this ‘fine’ crap.  There’s no way in _hell_ you’d accept that from one of your patients.”

 

Christine nodded in silent agreement and watched, amazed, as McCoy deflated, finally allowing the recovering patient to reemerge. 

 

McCoy sighed heavily, scrubbing his hands across his face.  “All right,” he admitted.  “Not ‘fine.’  Felt like my head was bein’ crushed and last time I got that sick….”

 

“Was when you got radiation poisoning by bein’ yourself?” Johanna interjected.

 

McCoy looked up in surprise.

 

“Oh yeah, I heard all about that,” Johanna fixed him with a glare.  “Jim told me,” she held up a hand to ward off any protest, “and before you say anything, he _told_ me to call him Jim, so shush.”

 

McCoy slumped back against the bed, exhaustion hooding his eyes.

 

Johanna bit her lip and ducked her head, softening her voice.  “But I can yell at you about bein’ a self-sacrificin’ idiot later,” she decided.  “Right now, I just wanna know how you’re doin’,” she repeated gently.  “‘Not fine’ but….” She prompted.

 

McCoy sighed tiredly before meeting his daughter’s eyes.  “But….better,” he said finally.  “The napromorphone’s brought the headache down from a 9 to a 1 and the nausea’s passed,” he clarified clinically.

 

“Now was that so damned difficult?” Johanna demanded, desperately pushing back the threatening tears.

 

McCoy grimaced as he shifted slightly in the bed.  “Didn’t want you to worry,” he said softly.

 

“Didn’t want me to worry?” Johanna repeated incredulously.  “It’s a little late for that Daddy!  Gettin’ a call that you’re essentially brain dead tends to be the worryin’ sort…..and I swear, readin’ your chart took a good year off my life!”

 

“Jo…” McCoy whispered.

 

“What did I say?” Johanna yelled, holding up a hand to quiet him.  Struggling to steady her breathing, she opened her mouth to continue the diatribe, but quickly found herself having to bring that hand to her mouth as the sobs finally refused to be ignored.  “You….” She tried to continue, but her voice cracked as the tears began to fall.  “What the _hell_ were you thinkin’, wakin’ up from cranial surgery vomiting?” she demanded, swiping furiously at her tears. 

 

“You did fine, sweetheart,” McCoy assured her gently.

 

“Yeah, right,” Johanna snorted, choking on another sob.  “Between my stupid phobia and worryin’ you were still gonna leave me from increased ICP, I almost joined you.”

 

“But you didn’t,” McCoy pointed out.

 

“Yeah, I know…..but…..stop turnin’ this around,” Johanna suddenly growled.  “I’m supposed to be yellin’ at you for dyin’ on me for six damned minutes…..then almost dyin’ on me again…..SEVERAL times,” she reminded him, sniffling angrily.

 

McCoy nodded silently and held out his arms.

 

“Dammit,” Johanna half-growled, half-whimpered as she threw herself into her father’s embrace, shaking the two of them with the force of her sobs. 

 

Christine swallowed back her own tears as she watched McCoy cradle Johanna to his chest, gently stroking her hair, humming softly through his own broken voice.

 

Mara stiffened as Johanna started to sob harder at the melody.  McCoy stopped and whispered something, seemingly apologetic, but Johanna hugged him tighter, appearing to insist he continue.  As McCoy began humming again, Johanna gradually began to quiet, wracking sobs diminishing to soft sniffles. 

 

M’Benga walked in as Johanna finally sat up and leaned forward, kissing McCoy’s forehead in such a mirror image of Christine’s greeting that Mara struggled to keep her own tears in check.

 

“Love you, Jo,” McCoy whispered, reaching up to smooth away the last few tears from Johanna’s face.

 

“I love you too, Daddy,” Johanna whispered back, grabbing his hands and kissing them before taking a deep breath and growling, “but don’t think I’m still not gonna tell you _exactly_ what I think about you ignorin’ a radiation leak, even if it _was_ in the line of duty.”

 

Christine couldn’t help but laugh at McCoy’s resigned sigh as she nodded M’Benga over to where she and Mara were standing.

 

Johanna glanced briefly at Christine, before turning back to her father, grinning slyly.  “You know…..I’ll bet Chris could tell me even more…..” she realized.

 

McCoy shot Christine a glare, which immediately softened to a smile as Christine threw up her hands and insisted that she wasn’t going to get involved.  McCoy turned back to Johanna with a tired, but satisfied grin.  “See?” he said, “At least _someone_ heah has the decency not to yell at recoverin’ patients,” he drawled.

 

“Oh please, like you never yell at your patients,” Johanna scoffed.  “And didn’t you hit a pregnant lady once?”

 

M’Benga smiled as McCoy and Johanna began debating the finer points of encouraging patient compliance.  He looked back to Christine.  “You wanted to see me?” he asked quietly.

 

Christine nodded, keeping half her attention on McCoy’s flagging voice.  “Leonard may have some memories of the accident and his treatment,” she said.

 

“Really?” M’Benga asked mildly.  He and McCoy had been compiling data for the last year or so on that very phenomenon, from crewmembers who had experienced near-death or out-of-body experiences.  It was a particular interest of M’Benga’s and Leonard had been eager to join in, citing the need for a better protocol in assisting those patients in recovery.

 

Christine recounted her conversation with McCoy.  “He was _so_ close to talking about it,” she groaned, before drawing in a deep breath and meeting M’Benga’s eyes again.  “Geoff, you know as well as I do, that if we don’t get him to talk about this soon, he’s going to bury it under his physical recovery and treatment studies.  It’s going to be hell just trying to get him to acknowledge it again.  I thought the chance was gone when Johanna came back in, but she got him to at least _admit_ he wasn’t perfectly fine.  I think we can get that moment back, but it means no more visitors until we’ve talked - especially the Captain and Mr. Spock.  As soon as they come in, Leonard’ll start reassuring them and looking after _their_ well-being.  We need to deal with this _now_.”  Christine insisted.

 

“Agreed,” M’Benga said simply.  “I’ll inform him that I’ll come back to do my assessment and answer his questions in an hour.  In the meantime, he’s all yours.”

 

Christine’s eyes widened.  “Are you sure you don’t want to stay?” she asked.  “You had more of a psychiatric rotation than I ever did,” she pointed out.

 

M’Benga shook his head.  “Don’t discount your own abilities, Christine.  Leonard trusts you, and _I_ trust you, for good reason.  If you both feel my presence would be of assistance, I would be glad to join the session later on.”

 

Christine nodded, touched.

 

M’Benga walked to McCoy’s side and greeted his friend, suggesting a plan for a full assessment, recovery schedule and chart review later that day.  Glancing down at the urinary collection bag hanging at the bedside, M’Benga turned to Christine.  “Christine, would you please d/c the urinary catheter while you do your morning routine?” he asked with a wink.

 

Christine smiled at M’Benga’s diversion – no good for McCoy to know what was really coming – it would just give him time to think of ways to avoid the issue.  “Of course, Doctor,” she replied.

 

“Sound good?” M’Benga asked McCoy.

 

McCoy nodded, stifling a yawn.  “Sorry, Geoff,” he said sincerely.

 

“I believe I recall you reminding patients that unconsciousness and sleep are _not_ , in fact, the same thing,” M’Benga smiled.  “I’ll leave you to Christine for now, then we’ll take the rest of the day as it comes.”

 

“Thanks,” McCoy smiled tiredly.

 

M’Benga nodded and headed for the doors.

 

Johanna leaned down and gave McCoy a quick hug.  “I’ll go wait outside,” she said.

 

“When’s the last time you ate, Jo?” McCoy asked, eyeing her critically.

 

“More recently than _you’ve_ eaten,” Johanna chuckled, “but I’ll go eat breakfast now.  Don’t worry – they _have_ been feeding me here,” she added with a smile.

 

Mara stepped forward, joining Johanna.  “I’ll go feed and walk her,” she grinned at McCoy.

 

McCoy waved them off with a small smile.

 

Christine closed her eyes briefly as the room quieted.  “Well, now that I’ve got you to myself again…..you ready to get that catheter out?” she asked McCoy with a soft smile, heading for the supply cart to gather what she needed.

 

McCoy was silent for a moment, watching the doors where Johanna had just left.  As Christine turned to walk back to the bedside, he suddenly spoke.  “Thank you,” he said quietly.

 

“What for?” Christine asked.  “I haven’t even taken it out yet,” she pointed out with a small smile.

 

McCoy was still looking at the doors.  “I heard you,” he said, so softly, Christine barely heard him.

 

Christine stood absolutely still.  “You remember?” she asked, just as softly.

 

McCoy nodded.  Staring straight ahead, he recited, “I have a patient here who insists on staying dead even though he’s been given every chance to live….”

 

Christine stifled a gasp as McCoy repeated her tirade in Engineering word for word.  “You weren’t responding to the RSR setting…..you’d been down for over five minutes at that point…..” she recalled.

 

“And all you wanted was a perfusin’ rhythm,” McCoy filled in.

 

Christine choked back a sob.  “Yeah,” she chuckled bitterly.  “And you gave me a damn idioventricular.”

 

“Well….” McCoy started, raising an eyebrow teasingly.

 

“Don’t you dare,” Christine laughed.  “I almost slapped the Captain when he pointed it out.  I guess I should’ve clarified that I wanted a _good_ perfusing rhythm.”

 

McCoy swallowed, hard.  Tearing his eyes from the doors, he met Christine’s gaze, eyes shining.  With a shaking breath, he said, “I remember you yellin’…..and it’s like I woke up without wakin’ up…..’cause I only remember wakin’ up heah befoah,” his accent flared with exhaustion and emotion.  He shook his head, frustrated.  “I don’t know,” he sighed.  He looked back at Christine, holding her shocked, open gaze in his intense blue.  “The only thing I’m _sure_ of,” he reiterated, “is that I just got to hold my little girl….and that it’s thanks to you, Chris.”  McCoy cleared his throat, shakily.

 

Christine abandoned all pretense of professional detachment and rushed to the bedside, enveloping McCoy in a fierce embrace.  “You have no idea how much I’ve missed you,” she choked.  “It’s _so_ good to hear your voice.”

 

McCoy took Christine’s hand gently as she straightened.  “Thank you,” he said, the simple words powerful in their sincerity, kissing her hand lightly.

 

“Anytime,” Christine whispered.

 

“Heaven forbid,” McCoy chuckled nervously.  He suddenly grinned, his eyes dancing with familiar mischief.  “For the record, you’re a pretty good shouter yourself,” he said.

 

Christine burst out laughing.  “Yeah, well, you’re a bad influence,” she grinned.

 

McCoy smiled.  “Ya’ll just don’t appreciate generations of McCoy subtlety,” he pronounced.

 

Christine snorted.  “Yeah, I’m sure that’s it,” she laughed.

 

McCoy grinned, settling back into the bed with a tired sigh.

 

Christine watched him for a moment before asking, “You want to talk?”

 

McCoy grimaced slightly, but nodded in agreement.  “I don’t really remember much else,” he admitted, “but we might as well get on with it.”

 

Christine nodded for him to continue.

 

McCoy raised an eyebrow.  “You gonna take notes?” he asked mildly.

 

“Why would I do that?” Christine asked, confused.

 

“For the study!” McCoy insisted.  “My head might be spinnin’ right now, but there must be _somethin’_ we can use rattlin’ ‘round in there.”

 

Christine wasn’t sure if her response was more a laugh or a sob.  _“Typical McCoy,”_ she thought to herself.  _“God, I’ve MISSED him.”_   She got up, grabbed a PADD, and sat back down on the edge of the bed, calling up the near-death/out-of-body experience study outline.  “You want me to take out the catheter first?” she asked.

 

McCoy shook his head.  “Nah, I didn’t even realize it was there ‘til ya’ll told me.  We’ve gotta get this data – it’s way past time for the stats review.”

 

Christine shook her head, laughing.  “All right, Doctor,” she smiled, looking down at the PADD.  “Tell me what you remember,” she began.

 

“You,” McCoy said softly as he closed his eyes.

 

For a brief moment, Christine couldn’t breathe, as McCoy’s voice warmed with a hint of the same indescribable faith that Jim Kirk often showed _him_.  Christine struggled under the weight of that emotion – sheer trust, gratitude and love…..and wondered, not for the first time, how McCoy wasn’t simply crushed by that force.

 

_“Well, Chris, you could start by breathing,”_ she decided.

 

She drew in a deep breath and let it out, infusing that slow exhalation with every positive thought she had.  _“I don’t know if any of this helped fix your sorry ass before,”_ she chuckled to herself, _“but I figure it couldn’t hurt either of us!”_

 

Wiping a single, relieved tear off the screen, Christine picked up the stylet and began to write.

**Notes for the Chapter:**

> Medical Notes:
> 
> \- “Aspiration” is when a foreign substance, such as food or vomit, enters the lungs, providing a breeding ground for bacteria (“aspiration pneumonia”). One of the ways to help protect the airway is to get the patient sitting up.  
> \- Mentions of the McCoy’s bullet wound and Tyree’s planet are from the second season episode “A Private Little War.” That episode always sticks in my mind as a strong look into McCoy’s personality as a healer and friend. His concern for Kirk’s emotional state overshadows everything, including his own injury from one of the native firearms. McCoy never mentions the wound and Kirk never notices he was even shot.  
> \- Again, references to Minara are from the third season episode, “The Empath.”  
> \- McCoy’s clinical clarification that the napromorphone brought down his headache “from a 9 to a 1” refers to one of the standard scales used in pain assessment. The scale goes from 0 – 10, with “0” being “no pain” and “10” being “severe/worst pain possible.”  
> \- ICP refers to “intracranial pressure.” A potential symptom of increased pressure on the brain, a possible complication of cranial surgery, is severe vomiting.  
> \- Johanna’s reference to McCoy hitting a pregnant woman refers to the second season episode, “Friday’s Child.”  
> \- Again, “d/c” stands for “discontinue.”


	13. Chapter 13

**Summary for the Chapter:**

> McCoy is critically injured and Christine Chapel does what she does best. A character study of Leonard McCoy and a look into the world of the Enterprise medical team.

 

 

Christine’s eyes slowly slid from the monitor readings back down to the PADD in her lap, stylet dangling from lax fingers as the silence lengthened.  After thirty minutes of diligent recollection, with fatigue cracking McCoy’s exaggerated Southern drawl down to a strangled, slurred whisper, the physician had finally quieted.  Christine had been ready to put the whole thing off about ten minutes into the discussion, psychological importance and her own recommendation be damned, but every time she had thought McCoy would _finally_ succumb to sleep, he had sucked in a disturbingly agonal-sounding breath and continued answering the study questions.  The one time she finally suggested picking up again later, McCoy had shot her a brief ‘are you insane?!’ look before wearily assuring her, “I can make it, Chris.”  Now, after five minutes of silence and comfortingly stable monitor readings, Christine shifted to the end of the bed and stood up, guiltily relieved that the decision had been made _for_ her.

 

“That all of ‘em?” McCoy croaked.

 

Christine sighed inwardly as she turned to see that McCoy hadn’t even been able to open his eyes in conjunction with this continued attempt to completely ignore his body’s demands.  It actually _hurt_ listening to him struggle to stay alert.  “Good enough,” she responded, mentally kicking herself as soon as the words left her lips.

 

McCoy managed to crack an eye open at that, eyebrow quirked as he drily replied, “Oh, really?”

 

Christine groaned as she berated herself for not thinking before opening her mouth.  Even in his weakened state, she could still hear the familiar, educated curiosity under the sarcastically tinged insinuation of ‘well then, please enlighten me’ in McCoy’s tone.  It was the same way McCoy replied to Kirk’s self-diagnosis of muscle strain, or Spock’s insistence that his elated smile at seeing Kirk alive again had nothing to do with pure, human joy - the tone that always preceded McCoy either forcefully, colloquially, or gently, but always compassionately, reminding the recipient why he was CMO of the Federation’s flagship.  It was also the tone that lab technicians only ever heard once – they learned very early on that there was no such thing as “good enough” with Leonard McCoy when it came to medical research.  Where other researchers saw “good enough” as equivalent to “well, it does what it needs to do”, McCoy saw the two words as an early concession, a refusal to look further.  Even when McCoy and his staff exhausted every possibility in a study, McCoy never said it was “good enough” – he specifically summarized their findings as “the best we can do with what we’ve got _for now_.” 

 

Of _course_ McCoy would take Christine’s words as a challenge.

 

“Well, that was stupid of me,” Christine conceded to McCoy with a rueful laugh.  “What I _meant_ to say was that there’s only one question left and it can wait.”

 

McCoy laughed weakly.  “Sorry,” he murmured, swallowing thickly before asking, “What question?” 

 

Christine sighed.  “Leonard….” She began, ready to insist that the question really _could_ wait another few hours.

 

“Chris, please,” McCoy’s voice was practically a whisper, but the pleading timbre that caught her attention was almost tangible.  “I _know_ I’m not bein’ real logical about this right now, but I just…..I need….” He threw one hand up weakly, struggling to find the words.

 

Christine’s eyes softened as the answer revealed itself in every line of his drained face.  Foggy blue wordlessly spoke for the exhausted creases: _“I need to figure out how to reestablish myself in a reality where I’m feeling pretty damn shaky right now.”_   “Okay,” she agreed gently, “but if you need to stop, or if your body _makes_ you stop, we _can_ finish later.  I promise I won’t forget.”  Christine Chapel was not one to make promises lightly – she held herself to every one she made, both as a matter of trust to her patients and as a matter of honor to herself.

 

McCoy nodded thankfully, knowing the significance in Christine’s choice of vocabulary.

 

Christine resumed her place on the side of the bed.  Sliding back a bit so her legs dangled comfortably over the hard floor, she met McCoy’s eyes.  “All right, last question,” she said, letting a small grin light her eyes.  “But I’m invoking the right to be creative with the wording, okay?  I promise to leave the scientific intent intact.”

 

“Go on,” McCoy chuckled softly.

 

“All right – first, a clarification,” Christine started.  “Now, I know this is the Enterprise and we’ve seen our fair share of impossible turned possible….and I recognize that we’ve got a whole study going on about near-death experiences and that you’ve even been involved in literally creating death and then bringing people back to life…..but this is _you_ , and it’s always going to be different when it’s _you_ ….so, I want you to tell me the truth – how are you doing with all this?”

 

McCoy was silent for a long while before he brought overwhelmed blue back to Christine’s open gaze.  “Honestly, Chris, it’s not the rememberin’ that bothers me……it’s everything I _don’t_ remember that’s got me more’n a little worried.  I mean, I know Geoff’s gonna do a full neuro work-up and mem’ry series when I’m awake enough to get through ‘em, but…..” he trailed off, rubbing his hands together absent-mindedly in his lap.

 

Christine laid a calming hand on McCoy’s anxious ones.  “So, let’s talk about what you don’t remember,” she offered. 

 

“Right - ‘s like askin’ the guy who’s horse just threw him on his head how many fingers you’re holdin’ up,” McCoy muttered darkly.

 

“What would he say?” Christine asked curiously.

 

“He’d ask which one of the dozen of you and the damn horse he’s seein’ through his concussed head you’re talkin’ about……then forget the question entirely,” McCoy grumbled, eyes flashing in memory.

 

Christine snorted back a laugh.  “At least this particular horse hasn’t damaged your sense of humor,” she pointed out.

 

“Better not have,” McCoy growled.  “I’m gonna need _something_ to get through the mess in there,” he rolled his eyes back to indicate his brain.

 

Christine waited quietly.

 

McCoy sighed heavily.  “Thing is, I don’t even know who the horse _was_ ,” he murmured, eyes darting nervously back down to his hands as he resumed the uneasy wringing. 

 

_“And there it is,”_ Christine said to herself, taking the weary admission for the opening it was.  To the trained ear, what those ten words were really acknowledging was a fear McCoy couldn’t properly voice:  _“I don’t know what happened, but I know it was bad, and all this uncertainty is scaring the hell out of me.”_

 

Christine felt a new wave of empathy surge through her.  Ask any crewmember what they feared most on this mission, and the answer was always the same.  From the security chief who set a new Federation sprinting record, to the geologist who had an almost paralyzing aversion to hyposprays, the biggest fear wasn’t physical pain or crippling injury…..it was losing one’s mind, being incapable of thinking clearly and rationally, of acting as the individual entity one was.  For McCoy, the man who once pre-operatively reassured a vascular surgeon with a traumatic amputation of his left hand by reminding him “least you still got your head straight, son – fixin’ this hand wouldn’t mean a damn thing if you’d severed cerebral tissue instead”…..well, it went double.

 

Christine steeled herself for that critical moment, where one hoped their words were enough to encourage that last leap of faith, past the innate defenses and into potential relief.  “Well, if all I had were a couple of fragmented outside reports to make sense of my equally fragmented head, I’d be more than ‘a little worried.’  I’d be freaking right the hell out.”

 

McCoy’s hands stilled, his eyes briefly widening before closing with a soft breath.  He sank further into the bed as some muscle-gripping tension finally slipped away on that relieved exhalation, a hint of an agreeing chuckle assuring Christine that she was finally ‘in’.  “Yeah,” McCoy sighed, half a rueful smile edging his lips, “guess that’s a little more accurate.”

 

Christine raised an eyebrow good-naturedly.

 

McCoy finally laughed.  “All right, a _lot_ more accurate,” he admitted, a tired smile lighting his face considerably for a few fleeting moments before the weight of worry clouded his features once more.  “I’ve got bits and pieces between you, Jo, and Spock hangin’ around in my head, but it’s like hearing an old Earth horror story, only the person reading just gives you the ending, leaving you scared _and_ confused because all you’ve got to go on is the terror in their voice from knowin’ the whole thing.”  McCoy looked up, embarrassed.  “Does that make _any_ sense?” he asked with a frustrated wave of his hands.

 

“More than enough sense,” Christine affirmed, before adding, “and it also reminds me why we stopped letting Lt. Sangren sit with his staff in recovery.”  Lt. Sangren was an old Earth horror aficionado who found comfort in the frightening tales.  When his subordinates ended up having to stay in sickbay longer for lack of sleep due to his bedside stories, the sickbay staff had finally limited him to five minute check-ins.  McCoy had obviously cared for a lot of the lieutenant’s staff before that particular ultimatum.

 

Christine smiled as McCoy’s eyes brightened again as he chuckled.  “He meant well, but I swear, we’d have run out of sedatives for those poor ensigns if we’d let him stay,” he recalled.

 

Christine laughed, watching McCoy’s face and body language for how to proceed.

 

McCoy gulped in another of those unsettling agonal-sounding breaths as he forced suddenly closed eyes back open.  Christine cringed at the memory of post-defibrillation dysrhythmias and cold Engineering grating under her knees.  She must not have hidden her fervent desire to shout at McCoy to knock it off very well, because the physician fixed her with a penetrating look.  “All right,” he drawled slowly, concern for Christine’s obvious discomfort overriding his own fear at knowing he had been the reason.  “So I was agonal at some point…..probably after the defibrillation where I remember you yelling…..which all led, according to Spock, to a cerebral shunt and another potentially _revolutionary_ Fabrini treatment to counteract a six minute anoxic episode.”  He stopped, worrying his bottom lip briefly before steeling himself to meet Christine’s eyes again.  “Now tell me about the horse,” he said quietly.

 

Christine let out a breath.  “M’Benga was going to fill everything in when you went over the chart later,” she began by way of explanation, suddenly finding herself inexplicably reluctant to recall the last several days.

 

McCoy rubbed his chest, forcing his eyes open once again.  Christine frowned.  “Is your chest bothering you?” she asked, concerned.

 

McCoy shook his head as he scrubbed a hand across his face.

 

Christine narrowed her eyes.  “Did you just give yourself a _sternal rub_?!” she demanded incredulously.

 

McCoy’s ducked eyes and lack of vocal defense were all the answer she needed.  “Dammit Leonard, don’t you think your body’s trying to tell you something?  I _swear_ , it doesn’t take a mind like yours to figure out you need to _sleep_ ,” Christine growled.

 

“Chris….” McCoy started.

 

“Leonard, we’re talking almost a week’s worth of information here,” Christine interrupted wearily.  “And as much as I know you _can_ keep forcing yourself to stay awake, I’m sure as hell not about to let you push yourself hard enough to undo all our, and _your,_ hard work.  I may be thrilled you’re awake, but don’t think that I still won’t sedate your ass if you keep this up,” she threatened.

 

McCoy sighed.  “Chris, you ever see the Kentucky Derby?” he asked.  Without waiting for an answer, he continued, “Nobody talks about every individual step the winning horse took – just the highlights – a time or two he stumbled or pulled ahead….and his name.  I realize that’s all I can handle right now and that’s all I’m looking for………just the highlights,” he finished, his voice barely a whisper.

 

Christine deflated under the force of that admission.  “I’m sorry, Len,” she said softly, squeezing his hand apologetically.  “I was out of line.”

 

McCoy squeezed back, reassuringly.

 

Christine drew in a breath.  “All right, the highlights,” she repeated, as she forced herself to separate the emotional memories tied with her upcoming words to that corner of her brain reserved for later thought.  Even though this was Leonard McCoy, the man who managed to infuse medicine with a startlingly compassionate wit, she found herself feeling unsure how to proceed.  If they were talking about any other patient….hell, even when she was talking to him while he was unconscious…..she would let her own blend of personal and professional sarcasm, long since refined by McCoy’s own, guide her speech….but at the moment, she was being rather pointedly reminded of the old phrase “cat got your tongue.”

 

“It’s just me, Chris,” McCoy read her mind, quietly alleviating her concerns.  “Go on,” he offered.

 

The sudden, affectionate urge to slap McCoy for being his usual compassionate self while in the midst of personal turmoil, spurred Christine on.  “Our shift was just about over….” She began.

 

McCoy groaned at the implication of those words.

 

Christine smiled.  “…when we went down to Engineering to treat Ensign Tenzin’s dislocated knee.  You were grumbling about solar flare mapping and all the shaking getting in the way of our procedure…..”

 

“That doesn’t sound like me,” McCoy pointedly grumbled, eyes sparkling.

 

“Right,” Christine snorted, relieved to feel the easy return of their give and take.  “What about yelling at the Captain to stop making our job so difficult?” she countered with a grin.

 

“I never do that,” McCoy couldn’t keep the laugh from his eyes at his attempted affront.

 

Christine laughed.  “Right, my mistake,” she chuckled.  “Now, do you want this information, or are you going to keep distracting me?”

 

McCoy sobered slightly at the renewed weight of uncertain anticipation, waving her on.

 

Christine bowed under the change in atmosphere.  “One of the flares changed position and hit the ship.  Hard.  You fell against one of the consoles as it exploded.”  She held a hand up, cutting off McCoy’s move to speak.  “Everyone else was _fine_ ,” she said.  “ _You_ weren’t.”  Christine swallowed hard against emotion-laden memory.  Clinical rationalization took over.  “R on T.  You were in cardiac arrest for six minutes, finally converting with direct defib, idioventricular to brady a-fib.  You were vented for agonal attempts, moved to sickbay where you had a pre-operative PE followed by a trip to the OR for massive cardiac and cerebral infarctions.  M’Benga did direct regen and reperfusion, tri-ox misting, cerebral shunt placement for further tri-ox therapy and CVC placement for drip titration.  You crapped out a few times in surgery and went into ARF in recovery.  Transcutaneous dialysis was successful.  Demcorzen eventually converted the a-fib.  Sedation withdrawal and follow-up cranial scans showed no improvement in higher functioning and the Fabrini compound was added to the tri-ox schedule, where you ended up with several hypotensive episodes and another arrest.  During your third lucid interval after recovery, you were unable to speak which led to Mr. Spock suggesting a mind meld, where you diagnosed the basal ganglia problem.  Regrafting and shunt removal were performed.  You woke up coherent, made everyone cry and have since apparently been rewarded with the headache from hell,” Christine finished on the edge of depleted breath. 

 

McCoy was silent, brow furrowing over closed eyes as if just the mention of the headache had been enough to bring the pain back.

 

“Len?” Christine asked softly.

 

McCoy didn’t respond.

 

Christine forced herself to look beyond her sudden surge of concern.  “Dammit Chris, give the man some time to process,” she chided herself.

 

McCoy was still for a long time before speaking.  “Sean’s all right?” he asked.  “We stabilized the knee?”

 

Christine nodded.  “Tenzin is fine,” she assured him.  “No problems with the dimzolam and the knee is good as new.”

 

“Scotty okay?  Lord knows he’d have been at one of those consoles with the ship screaming like that,” McCoy murmured.

 

“Didn’t I just tell you everyone was _fine_?” Christine chided gently. 

 

“Sorry,” McCoy sighed.  “I just….I have no memory of treating Tenzin….or even _being_ in Engineering,” he realized aloud.

 

“Those memories may come back – the time frame works for retrograde amnesia.  You certainly hit your head coming down, but I’d say just the anoxic injury _alone_ would be criteria enough,” Christine offered.

 

“Hmmm,” McCoy mulled the possibility before adding, “ _Three_ lucid intervals before the regrafting?  I don’t remember those either…..at least I don’t _think_ I do….” His closed eyes tightened in thought.

 

“You had a virdipan drip on board, so that could explain anything not covered by sheer unconsciousness,” Christine said.

 

“A virdipan drip?  Really?” McCoy asked, intrigued.  They managed most sedation with hyposprays and, in the infrequent cases where long-term sedation and amnesic effects were desired, the staff would occasionally use a long-acting transcutaneous patch.  Titrated intravenous drips were pretty rare in sickbay, even with McCoy’s old-fashioned tendencies.

 

“Down, boy,” Christine teased as McCoy’s interest was piqued.  “There’ll be time for details later, like when you can talk to me with your eyes _open_.”

 

“’M sorry,” McCoy slurred, starting at the sound of his voice and raising a hand to his chest.

 

Christine grabbed his hand halfway.  “Don’t even think about it,” she growled.

 

“Why am I so _tiahd_?” McCoy drawled wearily.

 

 Christine sighed dramatically.  “Did you even _hear_ that report I just gave you?  Each one of those _alone_ is enough for your body to demand sleep for the next few days.”

 

McCoy cringed at her raised voice, grimacing as his eyes tried to clamp shut even further.

 

Christine frowned.  “Is the headache back already?” she asked.  That was a little disconcerting – the medication should still be covering it.  Did they need to try something else?

 

“No, jus’ tired,” he slurred.

 

Christine narrowed her eyes, not caring whether McCoy could see her disbelief or not.  His deeply furrowed eyebrows, tight lips, clamped eyes, and careful avoidance of shaking his head in response to her question said otherwise.  She decided that McCoy might actually be so tired that he really _wasn’t_ sure if he was in pain again or not, so she decided the give him the benefit of the doubt, tucking his current nonverbal pain cues away for later assessment.  “Well, the ten of napromorphone coursing through your veins right now could also have something to do with that,” she teased lightly.

 

McCoy raised an eyebrow in surprised recollection.  “Damn opioids,” he groused.

 

“To be fair, it’s not a _pure_ opioid,” Christine pointed out with a grin.  “But I can still wait to take that catheter out until it’s done its job if you’d rather be asleep for that.”

 

McCoy cracked an eye open to glare at her clarification.  “Not a _pure_ opioid,” he repeated mockingly before chuckling softly with the joke.  “No respect,” he grumbled good-naturedly before closing his eyes again.  “You can take it out now,” he decided, “though I’m afraid I can’t promise I won’t fall asleep while you’re doing it,” he finished apologetically.

 

“You falling asleep while I d/c a urinary catheter would hardly be the rudest experience I’ve had as a nurse,” Christine laughed as she stood to gather the supplies.

 

McCoy laughed.  “I’d imagine not,” he said.  He sobered as she returned to the bedside.  “Labs okay?” he asked.

 

Christine nodded, grabbing the PADD to double-check the values.  “You did very well on short-term dialysis.  0400 BUN was 12, creatinine 0.9, GFR well over 60.”

 

“How low’d the output get?” McCoy continued.

 

“At its worst, under 10 ccs an hour,” Christine recalled, “but you’ve been well over 30 for awhile now.”  She knelt down to examine the catheter bag, calculating the current output.  “You’re at 50 right now,” she reported. 

 

McCoy’s grunt of approval and studious avoidance of nodding his responses instead of taxing his flagging voice didn’t escape her notice, but Christine let it go, keeping her attention to the task at hand.  “Okay,” she said, donning a pair of gloves, “I’m going to deflate the balloon now,” she narrated, as she engaged the small switch alongside the extra lumen, allowing the water filling the internal balloon to course harmlessly down the main lumen and into the collection bag.  Christine laid a towel under the catheter, on top of McCoy’s legs.  “All right, take a deep breath and on ‘three’, let it out slowly,” Christine continued.

 

“Go on,” McCoy acknowledged.

 

Christine grasped the catheter.  “1,2,3,” she counted, smoothly pulling the catheter out on McCoy’s exhaled breath.  She checked the catheter tip to make sure it was intact before wrapping the whole thing in the towel for disposal.  “Doing okay?” she asked McCoy.

 

“Fine,” he said.  “You’ll watch the time?” he asked tiredly.

 

“Of course,” Christine replied.  “I’ll link in a PADD alarm for the four hour mark as extra insurance.”

 

“Thanks, Chris,” McCoy whispered as his body finally began to lose its fight with sleep.

 

“You’re welcome,” she squeezed his hand gently.

 

McCoy’s eyes blinked open as he heard voices approaching the ICU doors.  “Is that Jo?” he asked, squinting at the tinted windows as he tried to focus on the sounds.

 

Christine laid a hand on his forearm, purposefully ordering the computer to dim the lights further.  “Jo, Mara, the Captain, and Mr. Spock….. at least,” Christine reported after listening for a moment.  “But I’m sure _they’ll_ understand the importance of you resting faster than _you_ did,” she teased.

 

McCoy opened his mouth, either to protest, retort, or both, but only managed a soft groan as his eyes closed of their own volition.

 

“Sleep,” Christine ordered gently.  “If they’re anything like me, they’ll be happy just to sit here and watch you breathe,” she said softly.

 

McCoy reached for her hand on his arm, gratitude infused in the light squeeze.

 

“You’re welcome,” Christine replied aloud, rubbing his hand gently as Johanna had done earlier.  “Now rest,” she repeated softly. 

 

McCoy let out a long breath.  His body relaxed, the lines in his face softening as the deeply furrowed brow began to ease.  Christine gently released his hand as the monitors continued their steady numerical depiction of stability.  She stood up, disposed of the catheter and washed her hands before charting the catheter removal and final output.  Setting the alarm for the four hour void check, Christine closed McCoy’s file, laid the PADD on the supply cart, and went to meet Johanna at the door.  

**Notes for the Chapter:**

> Medical Notes:
> 
> \- “Kirk’s self-diagnosis of muscle strain” refers to the second season episode “The Deadly Years.”   
> \- “Spock’s insistence that his elated smile at seeing Kirk alive again had nothing to do with pure, human joy” refers to the second season episode “Amok Time.”  
> \- “That you’ve even been involved in literally creating death and then bringing people back to life” refers to McCoy slipping Kirk a neuroparalyzing agent in the second season episode “Amok Time” to make it appear he was dead during the pon farr fight with Spock on Vulcan.  
> \- “Agonal” breaths are a sort of infrequent, gasping breath generally seen in the last moments of life.  
> \- A “sternal rub” involves rubbing one’s knuckles forcefully against a patient’s sternum (chest). It’s often used in unresponsive patients to see if they will respond to a painful stimulus. When it works, the patient usually gasps in a breath and/or opens their eyes.  
> \- McCoy groaning at the phrase “our shift was just about over….” refers to the fact that if something is going to go wrong in medicine, it’ll be at the end of your shift.   
> \- PE stands for “pulmonary embolism.” CVC stands for “central venous catheter” also known as a central line. ARF stands for “acute renal failure.”  
> \- The sedative “virdipan” in this story is related to modern day diprivan (propofol) which is a sedative with amnesic properties often used in critical care to keep patients sedated and help them not to remember the stresses and fears of being in intensive care.  
> \- “Napromorphone” is this story is meant to be a combination of an anti-inflammatory and an opiate, a combination often used today as the two medications complement each other, increasing the overall effectiveness and decreasing the amount of opiate needed. Opioids generally make people very tired.  
> \- The renal values and urinary output McCoy is checking on himself are all within normal range.  
> \- The references to “watching the time” and the “four hour void check” refer to making sure a patient is able to urinate on their own within four hours of having a urinary catheter removed.


	14. Chapter 14

**Summary for the Chapter:**

> McCoy is critically injured and Christine Chapel does what she does best. A character study of Leonard McCoy and a look into the world of the Enterprise medical team.

 

 

Johanna hurried through the ICU doors, so eager to return to her father’s side she never even saw Christine standing in the doorway until the nurse’s strong grip prevented the impending collision.  Johanna froze with a gasp and hastily cut off string of profanity, heart racing in her ears.  “Sh -, sorry Chris, I didn’t even see - ”

 

Christine shook her head.  “Don’t worry about it, Jo,” she whispered, nodding back toward the doors.  “Let’s go outside for a minute, okay?”

 

Panic flooded Johanna’s face as she struggled against Christine’s grasp to see past her to the biobed.  “What’s wrong?” she demanded breathlessly, eyes bright with anticipatory grief.

 

Christine swore under her breath.  She adjusted her grip on Johanna, letting one arm go so she could stand at the young woman’s side, allowing her a clear view of McCoy.  “He’s all right, Jo,” Christine said firmly.  “Nothing happened – he’s just sleeping, look,” she gently led Johanna through the monitor readings and focused the shaking woman’s eyes on the steady rise and fall of her father’s chest.  “He’s all right,” she repeated soothingly.

 

Johanna slumped against Christine’s grasp with a stuttered breath.  “He’s all right,” she repeated, the realization a shaky agreement.  She glanced up at Christine.  “I’m sorry, Chris…..I shouldn’t have…..”

 

“Stop apologizing – you’re starting to sound like _him_ ,” Mara muttered gently, nodding toward McCoy.

 

The words had their desired effect.  “Point taken,” Johanna chuckled softly.  “It _would_ be mighty hypocritical of me after I just accused him of doin’ the same thing, wouldn’t it?” she realized.

 

“Damn straight,” Mara agreed, waving a thankfully quiet Kirk and Spock back through the doors.  She gently took Johanna’s other arm, meeting Christine’s appreciative nod, before gently suggesting, “Shall we?”

 

Johanna let her eyes linger on McCoy’s sleeping form for another moment before nodding and allowing the two nurses to turn her around and guide her outside.  A token protest against being led to a chair died on her lips at Mara’s glare and she soon found herself meekly sitting down at the nursing desk, accepting a cup of water from a concerned starship captain.  She took a shaky sip and forced herself to steady her breathing.  _“Pull yourself together Jo – you’re acting like a damn child.  For heaven’s sake, you’ve walked people through this……get it together,”_ she berated herself.

 

Christine pulled up a chair, sitting across from Johanna quietly, watching the young woman’s face.  Mara silently gestured for Kirk and Spock to do the same, sighing softly once everyone was calmly seated around the desk.  No one wanted to be towered over while on the verge of an emotional breakdown.

 

Johanna closed her eyes and silently counted through the breathing exercise McCoy had taught her.  While sheer personality, finely honed sarcasm, and comforting scientific rationale generally got Johanna through life’s challenges, there was still a small ember of anxiety latent in her being, which, on the rare occasions it was fanned, exploded into a raging flame.  It took one particularly stressful day in high school where the fire was suddenly stoked and, hyperventilating in the choking smoke of fear, she passed out to the sound of blood rushing in her ears.  She woke up in the school’s medical office to her father’s nervous voice, an oxygen mask over her face, and cool, soothing fingers smoothing her hair back, quenching the lingering tendrils of flame.  Later that night, safe at home, curled on the couch with McCoy’s old-fashioned honeyed tea warming her hands, her father’s hands still gently stroking her hair, she shuddered at the barely concealed panic in his voice as he recalled the comm transmission, his rush to the school from the hospital, and seeing her ashen face against the classroom floor.  The sheepishness Johanna felt in hindsight as she related what had happened was immediately replaced with validation as McCoy clinically explained the rationale for her body’s physiological reaction, then quietly shared his own struggle with anxiety, from the first time he had stepped near a transporter.  Johanna had never considered that McCoy’s routine grumbling about “damn transporters scattering our atoms across space” was more of a front than anything – a way to give himself time before stepping on the pad.  While everyone would roll their eyes and comment on McCoy’s old-fashioned tendencies and growled distrust, McCoy admitted that he would take that time to silently work through a breathing exercise or two to get his anxiety under control.  When Jocelyn had walked in later that night to the sight of her husband and daughter sitting cross-legged on the couch, facing each other with closed eyes, quietly counting deep breaths in and out, she didn’t press them for details, passing it off as yet another manifestation of the often baffling medical mind.

 

It had been a long time since Johanna had needed to use it, but the steady rhythm of the exercise flowed easily through her body – in through her nose, out through her mouth, each breath a calmly timed equal to both its predecessor and successor.  Johanna felt her mind clear as her lungs relaxed under the renewed availability of oxygen, tissues calming under the even comfort of diffusion and transport.  She took a final, steady sip of water and looked up into Christine’s open eyes.  “I’m okay,” she said simply.

 

Christine smiled gently, secure in the relative truth of those words for the moment.  “There’s no shame in getting overwhelmed,” she offered.  “We’ve all been there.”

 

“Thanks, Chris,” Johanna snorted, “but I doubt any of you have ‘been there’ quite as spectacularly as _I_ just was.”

 

“On the contrary Johanna, there have been many strong emotional reactions to Dr. McCoy’s injury among the crew.  The seriousness of his condition and history of complications during treatment make your initial assumption quite logical……for a human,” Spock spoke up.

 

Kirk glanced at Spock with a knowing half-smile at the Vulcan’s careful clarification.  The fact that Spock just freely entered a conversation on human emotion, combined with the Vulcan’s mirror reaction to Kirk’s own sudden stiffness at Christine’s earlier words at the doors, spoke volumes of his own concern.

 

Christine bowed her head slightly in Spock’s direction, acknowledging his contribution.

 

Mara raised an eyebrow with a grin.  “Now _there’s_ validation for you – Mr. Spock declaring our emotional reactions logical,” she encouraged Johanna.  “Don’t think that happens every day around here,” she winked.

 

Johanna chuckled as Mara’s face softened and the nurse spoke again.  “You know, it doesn’t matter how many times you walk someone through the diagnoses, equipment, meds, and emotions – when it’s someone you love in that bed, that knowledge can only comfort you so far, before that same emotion you’ve eased others through takes over and throws all your educated control out the window.”

 

The room was silent for a moment as Johanna’s eyes widened at Mara’s words.  Johanna smiled as the much-needed reassurance soothed her internal frustration.  “You know,” Johanna grinned, “you’re pretty perceptive for a complete ass,” she teased.

 

Mara broke out in a wide smile as her earlier words were thrown back at her.  “You’re welcome,” she replied to the unspoken gratitude in Johanna’s eyes.  “But don’t go telling the rest of the crew – I’ll lose my threatening reputation.  Elise and Chris may get by on therapeutic relationships formed through sweetly worded rationale and psychiatric perception, but I’m too old to move beyond scathing sarcasm and glaring.”

 

Relieved laughter scattered through the circle while the tension in Spock’s shoulders noticeably eased.  Kirk’s eyes lost some of their haunted concern and Johanna’s blue cleared into open readiness. 

 

“So….” Mara drawled slowly, glancing around the room to make sure everyone was ready to move on.  “I’m assuming there’s a reason we’ve been kicked outside.  What’s up Chris?” she asked.

 

Christine flashed Mara a quick ‘I’ll thank you properly later’ look before gathering her thoughts and dividing her attention between Johanna, Kirk, and Spock.  “All right,” she began, focusing on Kirk and Spock.  “Did Mara and Johanna fill you in on Leonard’s morning?”

 

Kirk shook his head, frowning slightly.  “No, Spock and I came in right behind them – we didn’t get a chance to talk.  Was he still in pain?” he asked, recalling the physician’s first lucid period after the regrafting.

 

Christine nodded, filling Kirk and Spock in on McCoy’s headache and subsequent vomiting episode.  Kirk cringed, glancing at the doors, wanting to get to his friend’s side.

 

“The antiemetic took care of the nausea and vomiting and I gave Leonard a shot of napromorphone for the pain in case the earlier pain med contributed to the nausea.  He seemed comfortable after that and spent some time talking to Johanna before everyone stepped out so I could remove the urinary catheter.  He didn’t remember what had happened……”

 

Kirk looked up in concern.  “Amnesia?” he asked worriedly.  “But the kind that can happen with head injuries, right?  Where you can’t remember what happened right before the injury, but everything else is okay?”

 

“That’s what it appears to be, Captain,” Christine explained.  “At first glance, the rest of Leonard’s memories seem to be intact, but Dr. M’Benga will be doing a full assessment later on to be sure.”

 

Kirk nodded.  He had had enough concussions in his career to understand retrograde amnesia and he knew the seed of fear that bloomed when you realized you were missing time.  “What did you tell him?” he asked.

 

“He was already fighting sleep at that point, so I briefly explained what happened in Engineering, and then, with his insistence, highlighted the major points of his treatment,” Christine replied.

 

Kirk chuckled.  “And he yells at _us_ to sleep when we’re in sickbay,” he grinned.

 

Spock raised an eyebrow in agreement.  “Indeed,” he mused.

 

Christine smiled.  “I took out the catheter and finally convinced him to let the napro do its job.  He just fell asleep as you were all coming in.”

 

Kirk and Spock nodded, but Johanna’s eyes narrowed slightly, focusing on Christine with a familiar intensity.  “And?” she asked simply.

 

Kirk watched, fascinated, as Johanna looked right through Christine’s pause, as if she only had ears for the unspoken.  It always amazed him how Bones could see through his physical and psychological post-mission reports, listening calmly, nodding appropriately, then simply ignoring where Kirk put a period, seeing it as the comma it really was, and delving into the most important concerns, offering Kirk the words he needed to start giving the unspoken a voice.  Watching Johanna mirror the look he had been on the receiving end of many times, he wondered, not for the first time, just how many traits could be genetically transmitted.

 

Christine sighed, hoping Johanna didn’t somehow sense the rest of her conversation with McCoy.  The physician’s defibrillation memories weren’t something she was planning to take further than the medical record, and even there she had locked the report of that conversation under priority medical code one, accessible only to the CMO and Head Nurse.  M’Benga would have access as acting CMO, but no one else would be able to read that part of the medical record, including the Captain and First Officer.  Christine decided that, unless it became a major issue in his recovery, there was no need for anyone else to know about those memories unless McCoy himself decided to bring them up.

 

All this ran through Christine’s head in the space of a few seconds – too long a pause and a McCoy was bound to get even more suspicious.  “And,” she acknowledged Johanna, “I need all of your help.”

 

“What can we do?” Kirk asked, leaning forward eagerly, glad for something to do.

 

Christine sighed.  “Leonard appeared to be in pain again toward the end of our conversation.  He denied it when I asked, but he had some pretty strong non-verbal pain cues going on.  Now, he may have been so tired from the meds and everything else his body’s been through that he honestly didn’t realize he _was_ in pain, but I’m worried the napromorphone’s not cutting it – pharmacokinetically, it should still be working.  If it’s _not_ working, we need to know about it so we can try something else, so when he’s awake, if he looks like he’s in pain, ask.  If he denies pain, watch his body language.  Let one of us know so we can try to keep it under control – keeping the pain and nausea in line are major parts in keeping the recovery process moving.”

 

Johanna frowned.  “Napromorphone’s pretty strong stuff,” she worried aloud.

 

“Yes, but everyone’s chemistry is different,” Christine reminded her gently.  “There are other adjuvant meds and the pure opioids…..we just have to find the best fit for him…..and make sure he’s medicated before the pain is so bad that he starts vomiting.  Dr. M’Benga is going to want to start progressing Leonard’s diet to get him off the nutrition patch and IV fluids and that’s not going to go anywhere if he’s vomiting from uncontrolled pain,” she finished, briefly holding each individual’s gaze.

 

“Understood,” Spock replied, dark eyes lingering momentarily on Christine’s face.  Christine wondered at the flash of something…..approval?.....in his eyes.

 

Kirk nodded his understanding, gaze turning back toward the ICU.

 

“You don’t have to tell me twice,” Johanna scoffed.  “I didn’t come all this way to watch him regress.  I’ll keep him in line,” she promised.

 

Kirk’s laugh held a hint regret.  “Good – _one_ of us needs to.”

 

Christine smiled.  “Go on in and sit with him.  I’ll be there in a few minutes.”

 

Spock stood and waited as Kirk offered Johanna his arm.  Johanna took it, blushing, and the three left the room.

 

Christine turned to Mara with a heavy sigh.  “You, Mar, are a genius.  I wasn’t sure how I was going to dig myself out of that one.”

 

Mara laughed off the compliment.  “Please,” she scoffed.  “Just one of those rare instances where my abrasiveness actually _works_.” 

 

Christine rolled her eyes.  “Right,” she snorted.  “Like you had no intention of giving Jo _exactly_ what she needed.” 

 

Mara shrugged.  “Lucky guess,” she grinned.

 

Christine laughed.  “Yeah, well, _I_ know better, so thank you.  I wasn’t thinking – I would have freaked out too,” she admitted.

 

“I think you’re entitled to an occasional wrong move, Chris,” Mara pointed out with a soft smile. 

 

Christine returned the smile gratefully.

 

“You going to talk to M’Benga now?” Mara asked.

 

Christine nodded.  “Yeah, I’ll let him know about Leonard’s memory concerns and the pain issue and see where he wants to go from here.”

 

“Good,” Mara said, standing up and stretching with a yawn.  “Well, I’m gonna get some sleep.  I’ll see you tonight, okay?”

 

“I thought Elise was on tonight,” Christine frowned, trying to recall the schedule.

 

Mara ducked her head with an embarrassed grin.  “Yeah, well I _may_ have convinced her to switch with me,” she muttered.

 

“Mar, you’ve been on for a week straight!” Christine pointed out.  “Take the night off,” she said, exasperated.

 

“Please,” Mara snorted, “like you’ve had any time off since this whole mess started?  Or M’Benga, or even Sanchez?  If I didn’t _want_ to be here, I wouldn’t be, Chris.”  Mara paused, her cheeks flushing as she admitted, “Besides, I’ve really gotten to _like_ Johanna – she kind of reminds me of myself sometimes, when she’s not acting like a mirror image of her father.  You know I’m _far_ from the maternal type, but….” Mara cleared her throat as she tried to translate her thoughts.

 

Christine softened.  “You’d like to keep an eye on her?” she suggested.

 

Mara laughed nervously.  “Yeah, I guess that’s it,” she realized, bringing her eyes back up to meet Christine’s.  “How ridiculous is that?” she chuckled.

 

“I think it’s adorable,” Christine teased, her voice light, but her eyes were serious.  “You’re on her wavelength when she needs it most and she really responds to you.  I think it’s great, Mar, really,” she finished softly.

 

Mara made a face before brightening and clapping her hands with a bounce.  “Well, guess there really _is_ a first time for everything,” she laughed.  “I’m gonna go sleep before I say anything else profound,” she decided.  “Night, Chris,” Mara waved, heading for the main sickbay doors.

 

“Night Mar,” Christine waved back.

 

****

 

M’Benga looked up at the soft knock on the open door frame.  “Come,” he waved Christine into the office with a warm smile.

 

Christine sank into the proffered seat gratefully, watching as M’Benga signed off on the chart in front of him, closing the file and laying the PADD on the desk before turning and giving her his full attention.  “How are you doing, Christine?” he asked warmly.

 

Christine smiled at M’Benga’s natural calm and concern.  “Exhausted and stressed, as I’m sure _you_ are somewhere in there,” she teased lightly, “but okay.  We’re progressing.”

 

M’Benga dipped his head slightly in tacit agreement with Christine’s assessment, a quiet sign of his years working with Vulcans.  “I take it your conversation with Leonard was successful?”

 

“In a way,” Christine replied, rolling her eyes.  “We managed to get to the root of the memory concerns, but only at the expense of him resting.  I _swear_ , he gives the Captain 10 of napro and the man’s out for twenty-four hours…..but give the same thing to Leonard and the idiot fights it for over an hour by giving himself a damn _sternal rub_ every time his eyes close.”

 

M’Benga’s eyebrows went up at the mention of the sternal rub.  He shook his head, chuckling softly.

 

Christine couldn’t help but chuckle as well.  “It really shouldn’t have surprised me, but somehow it did,” she sighed good-naturedly.

 

M’Benga smiled.  “I’m sure Leonard insisted on getting through the whole study.  He has become quite invested in it, even though I have been collecting data for a longer period than he generally prefers.”

 

Christine nodded, unsurprised that M’Benga knew that McCoy would have brought up the study and insisted on contributing his own data to it.  “We got through the whole script,” she confirmed.  “His memories were confined to a narrow range of time during the defibrillation.  Everything is logged and coded,” Christine motioned toward the PADD.  

 

“What do we need to address?” M’Benga asked.

 

“He said he was okay with those memories, and I actually believe him,” Christine replied.  “His biggest concern is what he _doesn’t_ remember, retrograde and virdipan notwithstanding.  He knows you’re coming in later to fill in the details.”

 

M’Benga picked up the PADD.  “Is it all right….?” He began.

 

“Please,” Christine cut in, gesturing at the PADD.  “I can step out while you read over everything,” she offered.

 

“Please stay, Christine.  Sit for a few minutes.  Unless you need to leave?” M’Benga countered.

 

Christine shook her head.  “Mr. Spock and the Captain are in there with Johanna.  They know to call for me if Leonard wakes up and needs anything.”

 

“Good,” M’Benga decided.  “It won’t take me long to go through your notes and then I would appreciate your input on a few things.”

 

“Of course,” Christine replied, settling back in her chair.

 

Ten minutes later, M’Benga closed Christine’s notes, opening a blank plan document and resting the tip of the stylet on the screen thoughtfully.  “I agree with your assessment,” he said.  “I’ll complete the full neurological and memory series when Leonard is awake and address his concerns then.  From your notes, it does seem likely that the only losses he will have suffered will be minor amnesiac effects from the traumatic event and virdipan.”  M’Benga paused momentarily, smiling as he mused, “Which would be _incredible_.”  He continued, “I appreciate and support your coding of those memories.  We will support him psychologically as needed.  I have already begun breaking up the treatment notes into small sections for Leonard to read once he starts looking for his chart.  That way, he can feel productive while you and Mara can control how much he receives to read based on how much he’s fighting sleep,” M’Benga smiled knowingly.

 

Christine grinned.  She was one of the lucky few who got to see M’Benga’s rare devious side.  “And I’m sure you’ve got the chemical analyses of the Fabrini compound front and center,” she teased.

 

“I must admit, it would be _my_ first request as well,” M’Benga laughed.  “I look forward to discussing it with Leonard.  I know Michael is already longing for the lab to study it further.”

 

Christine smiled.  “I’ll bet he is,” she replied.  Poor Sanchez probably couldn’t _wait_ to get out of sickbay and back into the labs.

 

“Now,” M’Benga brought his focus back to the PADD.  “As for physical recovery….you d/c’d the catheter?”

 

Christine nodded.  “I forgot to ask you about the fecal catheter before, so I left it in for now.  He’s going to hate using the urinal later, but I’m not planning on getting him up just yet.”

 

“Problem?” M’Benga read her concern.

 

Christine recalled McCoy’s headache and vomiting episode, her treatment, and the seemingly subsequent resurgence of pain before he succumbed to sleep.  “I just don’t like it,” she admitted.  “This is the second pain episode since the regrafting and shunt removal and it seems to be only marginally responsive to acetodone _and_ napromorphone.  I know the shunt is something different, but we _never_ have this kind of almost refractory pain after cranial surgery anymore.  He seemed to respond well to the antiemetic during the crisis, but if the pain reaches that critical level again, we’re never even going to get him on _clears_ , let alone progress enough to d/c the patch and fluids….and forget about getting him on his feet,” she worried.

 

M’Benga frowned.  He brought up a file on the PADD and scrolled through the data, tapping his free hand lightly against the machine as he read.  After a few moments, he looked back up at Christine.  “What if it’s a side effect of the Fabrini compound?” he suggested.

 

Christine’s eyes widened in surprise.  “I…. never even thought of that,” she breathed.

 

M’Benga glanced back down at the PADD.  “Considering this is quite literally the first time it has been used on a humanoid and we didn’t know what to expect in terms of efficacy……it would follow that the side effect profile would be just as uncertain.”

 

“That could explain both the existence _and_ persistence of the pain,” Christine thought out loud.  “Maybe it’s only responsive to a specific analgesic….it’s not like we can really pinpoint the origin of the pain and prescribe accordingly.”

 

“True,” M’Benga said.  He brought his plan up again and added a few notes.  “I’m going to write up an algorithm with a few different pain medications for you and the nurses to work with.  I want you to keep me informed with your assessments and suggestions please.”

 

“Of course,” Christine agreed, glad to have something else to work with. 

 

“Controlling the pain and nausea will be our top priority for right now,” M’Benga reiterated.  “Those will affect everything else.  Once we have that under control, we can proceed with the standard diet and activity plans.  The nutrition patch is sufficient for necessary intake and the fluids will keep him hydrated for now.  I’m more concerned about getting Leonard up and moving than anything.”

 

“All the range of motion in the galaxy isn’t going to prevent at least some atrophy and weakness?” Christine filled in.

 

“True,” M’Benga nodded.  “But more than that.  If I know Leonard, he’s going to insist on getting up even if he is still in significant pain.  He will want that feeling of normalcy.”

 

“And if _I_ know him, he’s going to be mad as hell at that weakness, so we’re going to have to really watch him and come up with a balance – getting him moving to strengthen those muscles, encourage blood flow, and keep the depression of being bedridden at bay, but also remind him it’ll be a slow process in the beginning and make sure he doesn’t do something stupid like fall on his face,” Christine added.

 

“Agreed,” M’Benga said.  He closed the file, but kept the PADD on his lap, tapping the stylet along the hard edge.

 

Christine frowned.  It wasn’t like M’Benga to fidget – the man was one of the calmest people she knew.  She thought back to the beginning of their conversation.  “You said you wanted my input on some things,” she recalled.  “Am I safe in assuming we haven’t gotten to those things yet?” she ventured.

 

M’Benga smiled sheepishly.  “Most perceptive, as usual,” he chuckled.  He pushed a deep sigh through pressed lips.  “We _do_ have other concerns,” he began.

 

Christine nodded for him to continue.

 

“We have been fortunate up to this point,” M’Benga said slowly, pulling his thoughts together.  “And while I commend Captain Kirk on his silence and ability to get Johanna on board, the fact remains that Lt. Uhura will have to send the biweekly reports to Starfleet soon.  I’m sure it will not go unnoticed by Starfleet Medical that it was _I_ , rather than Leonard, who signed off on all this week’s charts and reports.”

 

“Let alone the fact that Leonard’s chart will be included in that transmission, making it pretty damn obvious he’s been a patient for the last week,” Christine groaned in realization. 

 

“Precisely,” M’Benga sighed.  “I am only supposed to act as CMO by the true CMO’s order, or Starfleet Medical’s order, if the CMO is otherwise unable to transfer the responsibility.  I took the position briefly after Leonard stayed on Yonada, but only because the Captain informed Starfleet and I received orders to do so.  I do not believe Starfleet will allow us to use the emergency provision to explain an entire week.”

 

“Shit,” Christine ground out.  “He’s not even supposed to _be_ here according to regulation.”

 

“Yet another issue to address,” M’Benga murmured.  “A patient this critical, especially with his poor prognosis earlier, should have been moved to a Starfleet facility as soon as they were stabilized.”

 

“But he never would have had a chance then!” Christine shouted, hands flying in angry punctuation.  “They wouldn’t have known about Leonard’s theories, let alone even _entertained_ the thought of a cerebral shunt or the Fabrini research.  He’d have gone to a critical care facility for evaluation, been declared hopeless, then sent to rehab to live out whatever time he had left in a state he never wanted to _be_ in in the first place!”

 

“I don’t deny that we made the right decision,” M’Benga said quietly.  “I only wonder, as Leonard would put it, ‘how in blazes we’re going to get _out_ of it.’”

 

Christine let out a rough breath, collapsing back against the chair.  “I’m sorry, Geoff,” she sighed.  “It’s just….it shouldn’t always come down to protocol.”

 

“I agree,” M’Benga replied, tapping the PADD again thoughtfully.

 

“Well,” Christine sighed, “it’s not like they can _undo_ what we did.  We just need to figure something out.”

 

“Yes,” M’Benga murmured.

 

“It’s not like it’ll be the first time,” Christine snorted.

 

“True,” M’Benga chuckled softly.

 

“All right,” Christine sat up straighter, forcing herself to think logically.  “The Captain came up with a story to explain how we got Johanna on board, but that’s not going to cover everything else, and I’m _sure_ he knows that.  He’s got to be thinking about how to keep the rest of the charade going.  We still need to finish the flare mapping, and somehow get Jo home.”

 

“If the Captain can get us back to Earth, I may be able to get Johanna back home,” M’Benga spoke up.

 

Christine raised an eyebrow in surprise.  “Why, Dr. M’Benga, are you _scheming_?” she grinned.

 

M’Benga laughed, the tension in the room easing noticeably.  “I would like to submit that I have only begun to think this way since accepting this post.”

 

“Psh, that excuse won’t go anywhere,” Christine laughed.  “We may be a bad influence, but you _had_ to have had a little seed of deviousness already there for it to start growing in our dubious presence.”  Christine watched M’Benga flush momentarily before focusing on his previous statement.  “What are you thinking?” she asked.

 

M’Benga pulled up several files on the PADD, scrolling through them as he spoke.  “Leonard has been documenting, for the last several weeks, that the crew is in dire need of shore leave.  I agree completely.  If the Captain can determine a reason to get us to Earth, I believe I could convince Starfleet to grant the time.  It has been almost two years since the crew had time on Earth and Leonard even went so far as to suggest some rock-climbing time for the Captain, as a stress reliever.”

 

“Wow,” Christine breathed.  “Leonard is nothing _but_ stress when the Captain does that.  He must really think he needs it.”

 

“Apparently so,” M’Benga agreed.  “I’m sure Mr. Scott could arrange transport for Johanna back home once we’re in orbit.”

 

“No doubt,” Christine chuckled. 

 

“However, I’m not sure how to bring up the suggestion,” M’Benga admitted, looking to Christine for suggestions.  He wasn’t quite as comfortable offering unconventional ideas to Captain Kirk as McCoy was.

 

“I’m willing to bet the Captain is going to come to you first,” Christine replied.  “When he’s got a mess on his hands, he generally gathers the senior staff together and everyone tosses out ideas until a plan comes together.  Uhura seems to think the Captain’s working up to that right now.  As acting CMO, he’ll want your opinion.”

 

M’Benga nodded thoughtfully.  “One can only hope they’ll at least be willing to _hear_ about this treatment once they’re through court-martialing us,” he sighed heavily.

 

Christine leapt from her seat.  “That’s it!” she cried, breaking into a huge grin.  “We bring the treatment data directly to Starfleet Medical – a personal presentation of a revolutionary treatment for anoxic brain injury.  Hell, we could even collaborate with Dr. Kerebus and his team to put the whole thing together.  This is one of those rare times when we really get to go above and beyond the mission, when we find something that could _save_ life, instead of destroy it.  Think about it Geoff…..give Leonard a chance to recover enough to review this data and he’ll give them a preliminary report that’ll knock their socks off!”  Christine paused, shaking her head.  _“Dammit, there goes another one of his expressions,” she _realized.  She was picking up far too many of McCoy’s phrases.  Beaming at M’Benga again, she continued, “They’ll _have_ to take that into account – if we had gone by the book, we _never_ would have found that treatment.  It _has_ to count for something.” 

 

M’Benga smiled brightly.  “It just might work,” he chuckled.

 

“It _will_ work,” Christine insisted.  “And when the Captain calls everyone together, you’re going to tell him.  It may be just what he needs to finish off whatever plan they’ll come up with.”

 

“All right,” M’Benga laughed.  “Well done, Christine.”

 

“Please,” Christine insisted sincerely.  “You started it.”

 

M’Benga inclined his head in gratitude, looking up as Tom knocked on the door frame.  He hurried to his feet at the blood covering Tom’s arms.  “What happened?” M’Benga asked quickly.

 

Tom held up his bloody hands in a rushed, placating gesture.  “The worst of it is over, Doctor,” he assured M’Benga.  “Pryers decided to lacerate himself on a panel the day he was due for his coag shot.  The bleeding’s stopped, but you may want to readjust his dose.”

 

M’Benga took in the volume of blood on Tom’s arms.  “Indeed I will,” he agreed, shaking his head.  He glanced back at Christine.  “Do you need anything else, Chris?” he asked.

 

“Go take care of Pryers,” Christine insisted.  “I’m going to go check on Leonard now.  I’ll call you if we need anything.”

 

M’Benga nodded as he grabbed the PADD, pulling up Pryers’ file as he followed Tom out.

 

Christine stretched as she walked over to the desk and took an extra PADD, bringing up M’Benga’s pain med algorithm to review as she walked to the ICU.

 

****

 

“I swear, Captain….Jim,” Johanna corrected herself, “I don’t know how ya’ll eat this replicated stuff.”

 

Kirk shifted on his chair at McCoy’s bedside with a chuckle.  “What did you have?” he asked.

 

“It _said_ it was cornbread and sweet tea,” Johanna said disbelievingly.

 

“Well, if that’s what the card said……” Kirk offered. 

 

“Just ‘cause a chicken’s got wings don’t mean it can fly,” Johanna interrupted with a grumble.     

 

“I…..suppose that’s true,” Kirk laughed, taking a moment to run the expression through his head.  “Bones is always complaining that plastiskin has more flavor than the grits.”

 

“I don’t even want to _think_ about how badly they messed _that_ up.  It’s an insult to Southerners everywhere,” Johanna cringed.

 

“I have to be honest, Jo,” Kirk ventured, “I don’t know how you eat grits at _all_ , replicated or not.”

 

“Eh, what do you know?  You’re from _Iowa_.  What did _you_ eat for breakfast back home?” Johanna asked.

 

“Bacon and eggs almost every morning when I was a boy,” Kirk smiled at the memory.  “My mother could turn this _chair_ into a gourmet meal.”

 

“And you’re telling me that when you order bacon and eggs from the replicator, that it tastes just like your momma’s cooking?” Johanna challenged.

 

“Not a chance,” Kirk denied emphatically, grinning at Johanna’s triumphant smile.

 

“Does it do any better with Vulcan food?” Johanna asked, glancing back at the doors.  Spock had excused himself to the Bridge once he noted McCoy was sleeping deeply, insisting that Kirk take the time to visit and that he would return later.

 

“You’d have to ask Spock,” Kirk said.  “Although he’d probably just tell you that the purpose of food is to supply nutrients to the body and that it doesn’t have to _taste_ good to do so,” he admitted with a chuckle.

 

Johanna rolled her eyes.  “Yeah, well, when I get home, I’m gonna cook ya’ll some _real_ Georgia cuisine.  I’ll bet even Mr. Spock’ll realize what he’s been missing,” she grinned.

 

“You should take her up on it, Jim,” a tired voice drawled from the bed.  “Jo makes a Georgia peach pie known from here to Orion.”

 

“Hiya, Daddy,” Johanna smiled brightly, leaning down to give McCoy a quick hug.  “Flattery’ll get you nowhere,” she teased.

 

“I just got a hug, didn’t I?” McCoy countered, blinking his eyes open most of the way.

 

“Yeah, but I was gonna give you one anyway,” Johanna said.

 

“Well then, chalk it up to an old man bein’ proud of his little girl,” McCoy replied.

 

“Mush head,” Johanna smiled affectionately, grabbing one of McCoy’s hands and kissing it lightly.  “How’s your headache?”

 

“It’s all right,” McCoy answered, shifting slightly on the bed.

 

Johanna narrowed her eyes.  “Are you lyin’ to me?” she demanded suspiciously.

 

“Wouldn’t you tell me if I was?” McCoy countered.

 

“Damn straight I would,” Johanna growled, eyeing McCoy, looking for any attempts to hide pain cues.  “But I believe you for the moment.”

 

“Thank heaven,” McCoy chuckled, trying to hide the resulting cough with a fist to his mouth and a quick clearing of his throat.

 

“Bones, how is it?” Kirk finally asked quietly from behind Johanna’s scowl.

 

“I’m all right, Jim,” McCoy replied softly, turning a perceptive gaze to Kirk.  “Are _you_ all right?” he asked.

 

“Me?” Kirk repeated with a surprised huff of breath.  “I’m not the one in an ICU bed, Doctor,” he pointed out.

 

“And I’m not the one drownin’ in guilt in that there chair, _Captain_ ,” McCoy countered, one eyebrow raised, challenging Kirk to deny it.

 

“How…..I’m not…..” Kirk sputtered.

 

“Please,” McCoy retorted, rolling his eyes.  “I don’t need no Vulcan ears to hear you blamin’ yourself for my bein’ here.”

 

Johanna watched Kirk crumple under McCoy’s focused stare.  Standing up slowly, she quietly excused herself, unsurprised when the two men barely nodded, unable to look away from each other.

 

As the doors swished shut behind Johanna, Kirk finally let go.  “Bones, you….I should have….” He threw up his hands up in frustration as the myriad thoughts rushing through his head refused to submit to order.

 

“Should have what, Jim?  _Ordered_ that flare not to hit the ship?  I’ll admit I don’t know much about solar flares besides the fact that Starfleet spends _way_ too much time on them, but I’m pretty damn sure they don’t take orders from ruminating starship captains, even if their name _is_ James T. Kirk,” McCoy said.

 

Kirk sighed heavily, rubbing the back of his neck tiredly.  “I know, but….”

 

“Well if you _know_ , then why’re we still talking about it?” McCoy countered.  He sighed, his voice softening as he continued, “Look Jim, I don’t even remember _bein’_ in Engineering before this all happened, but Christine told me enough.  You pulled the ship back so we could treat a patient, one of the flares moved and hit the ship, and I just happened to be in the wrong place at the wrong time.  It happens, Jim, and whether we like it or not, there isn’t always someone to blame.  This time’s no exception.”  McCoy closed his eyes briefly, stifling a yawn.

 

Kirk looked up with a smile.  “That napro-something stuff is sure knocking you out, huh Bones?  Nice to know I’m not the only lightweight when it comes to your drugs,” he teased, the lightness of his tone and change of subject reassuring McCoy that he had accepted McCoy’s words; that he would be all right.

 

“Please,” McCoy snorted.  “Least _I’m_ awake.  You’d still be out for a good twenty hours at a _fraction_ of the dose.”

 

Kirk frowned.  “Wait a minute…..is that the stuff you give me…..”

 

“Every time you throw that disc out pullin’ some damn fool stunt?  That’d be the one,” McCoy confirmed.

 

“I _hate_ that stuff,” Kirk complained.  “By the time I wake up a whole day is gone!”

 

“How else you expect me to keep you off your feet?” McCoy grumbled.  “You’re lucky you haven’t needed surgery on that back of yours yet.  You can’t just slip it back in place and go on your way, Jim.”

 

“Yeah,” Kirk grudgingly agreed.

 

“Besides, it works, right?” McCoy asked.

 

“Definitely,” Kirk said, “It’s like I was never even _in_ pain.”

 

“Good,” McCoy caught himself mid-nod.  “And it’s called ‘napromorphone’ - so you know for the next time Spock carries your sorry ass in here,” he said, opening his eyes slightly so Kirk could see the spark there.

 

“Such insubordination, Doctor,” Kirk tsk’d, eyes dancing.

 

“Just try an’ report me,” McCoy grouched good-naturedly.  “You think anyone _else_ would put up with you and Spock?”

 

 “Hmm, good point.  In that case, I’m forced to look at that sentence as a shining example of your medical expertise, leaving me no choice but to keep you as my CMO,” Kirk decided, a grin threatening the mock-seriousness of his tone.

 

“I’m overjoyed,” McCoy drawled, closing his eyes again with a small smile.  He was silent for a few moments before noting, “You and Jo seem to be gettin’ on well.  I don’t know how you got her on board Jim, but thank you.”

 

“My pleasure, Bones,” Kirk replied softly.

 

“Really Jim, how’d you get her here?” McCoy persisted.

 

“It was a group effort,” Kirk tried to shrug it off.

 

“Jim….” McCoy threatened, opening one eye with a groan as he heard Kirk use the same tone he adopted while trying to hide injuries from the physician.

 

Kirk sighed at the strength McCoy managed to infuse through an exhausted, drugged, one-eyed glare.  “I may have put off an order…..and warped to Starbase 8 to beam Jo on board from a medical transport,” he hedged.

 

“You what?!” McCoy nearly shouted, bolting upright before falling back with a strangled cry.

 

“Bones!” Kirk lurched to his feet, laying a nervous hand on McCoy’s shaking arm.  “Bones - ”

 

“Jim, just how many times you think Starfleet brass is gonna let you get away with this kind of crap?” McCoy gasped, ignoring the worry in Kirk’s tone.

 

“I’ll think of something,” Kirk insisted, cringing at McCoy’s gritted teeth and half-moaned breaths.  “Bones, maybe I should - ” he glanced nervously at the doors.

 

“Jim, listen to me,” McCoy choked, gingerly bringing his free hand up to his temple.  “I appreciate what ya’ll have done, but you can’t go puttin’ yourself on the line for me like that.”

 

Kirk tightened his grip on McCoy’s arm as his eyes somehow managed to darken and soften at the same time.  “Bones, there are very few people I consider _worth_ putting myself on the line for.  You’re always going to be one of them, so get used to it,” he said firmly.  Cutting off McCoy’s attempted response, he added, “Contrary to popular belief, I don’t ignore orders whenever I want to – only when I feel it is morally, ethically necessary…..when it’s really worth it.  Say what you want about yourself, Doctor, but you’re worth it.  And until Starfleet understands that fact, I stand by my decision.  If I had followed protocol, we wouldn’t be having this conversation right now.  Starfleet Medical would have declared you brain dead, removed you from the Enterprise, and expected me to get on with a new CMO…..and _over_ the loss of my friend.  I found it unacceptable,” Kirk finished quietly, struggling to clear his throat.

 

The room was silent but for McCoy’s shaking breaths.  “Jim, I….” McCoy turned to meet Kirk’s eyes and immediately paled.  “Uh, Jim….I sweah this has nothin’ to do with what you just said…” McCoy drawled, his voice pinched as he motioned toward the basin across the room.

 

Kirk’s eyes widened as McCoy lost what little color was left in his face.  He bolted to his feet, grabbed the basin and thrust it in front of McCoy just in time for the physician to violently heave up what little bile remained in his stomach.

 

Christine and Johanna came running in at the sound of retching.  “What happened?” Johanna demanded, skidding to a stop at McCoy’s bedside.

 

“I _moved_ ,” McCoy groaned, choking back a cry as another spasm hit, jostling his careful attempt to control his head.

 

“Hang onto him – I’ll raise the bed,” Johanna urged Kirk, reaching for the button to bring the head of the bed up a full 90 degrees.  Kirk held onto McCoy’s arm with one hand, the basin in the other, steadying the physician until he was upright.

 

Christine rushed to the bedside with two hypos in her hand.  She administered the antiemetic quickly, giving McCoy a chance to catch his breath before continuing.  “Give me a number,” she ordered.

 

“8,” McCoy shuddered once he was able to speak, eyes clenched shut, desperately trying to keep as still as possible.

 

“There’s a 10 on that scale for a reason, Daddy,” Johanna grumbled, eyes flitting to Christine nervously.

 

“All right, Len, I’m going with 4 of laudilone,” Christine said, adjusting the dosage on the second hypo.

 

“The napro might still work,” McCoy gasped, shaking hands still desperately attempting to find the appropriate pressure points.

 

“Yeah, look how well it’s working,” Christine retorted.  “M’Benga wrote up orders to get this under control.  We’re beyond napro at this point, so unless you’ve got some anaphylactic history we don’t know about, we’re trying the laudilone _now_ ,” she said firmly.

 

McCoy nodded his consent by force of habit.  Kirk and Johanna gasped as McCoy’s eyes flew open with a strangled cry at the movement, then rolled back, leaving the physician limp on the bed.

 

“Shit!” Christine ground out under her breath as she hurriedly administered the laudilone, tossing the hypo on the bed and watching the monitors for anything critical.

 

“Bones?” Kirk’s hushed voice just barely managed not to shake.

 

Johanna grabbed McCoy’s hand tightly, forcing back tears as she watched Christine observing the monitors.  “Anything?” she choked out.

 

“Vitals are steady,” Christine reported softly.  “It looks like he just passed out from the pain.  Give the meds another few minutes to work.”

 

A minute later, McCoy’s eyes slowly opened.  Blinking sluggishly, he gingerly turned toward the pressure on his left arm and hand.  Seeing Kirk and Johanna, he managed a tired, lopsided smile.  “Sorry,” he murmured.  “Did I just pass out on ya’ll?”

 

“Yeah, you did, Daddy,” Johanna replied softly.

 

“Sorry ‘bout that sweetheart,” McCoy squeezed Johanna’s hand lightly. 

 

“’S’all right, Daddy,” Johanna whispered.  “But next time Chris is fixin’ to give you something, no more wastin’ time arguin’, okay?”

 

“Okay,” McCoy agreed.

 

“Good,” Johanna nodded, satisfied for the moment.

 

“Sorry, Jim,” McCoy sighed.  “Meant to thank you, not throw up on you,” he chuckled softly.

 

“I figured,” Kirk laughed, letting some of the tension go.  “You’re welcome,” he said seriously.

 

“How’s your pain now, Len?” Christine asked softly from McCoy’s right.

 

McCoy slowly turned to face her.  “1,” he replied, swallowing thickly.

 

“Nausea?” Christine pressed.

 

“Gone,” McCoy affirmed.

 

“All right,” Christine blew out a breath.  “Let’s see how this one works.  Close your eyes,” she said gently.

 

As McCoy’s breathing evened out into narcotic-induced sleep, Kirk squeezed his shoulder and stood up to return to the Bridge.  “Call me if you need me,” he insisted to Johanna, hugging her lightly as she leaned into the hand he laid on her arm.  “I’ll be back later.”

 

“I’ll keep you informed,” Christine replied to the unspoken question.

 

Kirk nodded and with a final glance at McCoy and Johanna, he left the room.

 

***

 

“I’m telling ye Mr. Spock, Gunny got those scanners functioning better’n even the new models,” Scotty insisted.

 

“One successful test does not equal the years of published data on the current power source, Mr. Scott,” Spock replied.

 

“Well of course not, Mr. Spock,” Scotty agreed.  “An’ that’s why Gunny’s paper’s up for review right now….an’ it’s not as if he’s actin’ alone.  The tests are bein’ replicated by at least two dozen engineers that I know of personally _,_ let _alone_ what studies’ll be produced after his work’s published.”

 

“The cost of tirilium….” Spock began.

 

“Is nothin’ compared to what it saves in producin’ whole new models….an’ that’s not even countin’ the fact that it wipes out the whole problem with the warp core frequency,”  Scotty interrupted.  “I substituted the tirilium into one o’ our biphasic scanners right here an’ not only did it work faster and more efficiently than the newest model Starfleet’s insistin’ we convert ta, but it finally allowed us to pick up on the one warp core frequency we can never monitor until she’s about to rip apart!” Scotty beamed.

 

Spock paused.  “Indeed?” he mused.

 

“I’ll show ye the scanner myself,” Scotty offered. 

 

“I would be most interested in observing that effect,” Spock agreed.

 

“That’s why I think it’ll make such a good addition to the life support systems,” Johanna leaned forward eagerly.  “The mechanics are incredible – it’ll give us the ability of havin’ the machine literally ration out the power supplied to it!  Instead of one steady source that doesn’t always last as long as the patient needs it…….you ever have to change a power unit on one of those things, knowin’ it’s the only thing between that patient and heaven?!  Anyway, with the tirilium, the machine can adjust the power as needed to each function bein’ used and even store extra so it can act as its own generator.  So, instead of all that power goin’ to every possible function on a patient only needin’ the machine for ventilatory support, we could not only cut down on the power needed for that one function, but also store up the excess for emergency power loss.  It may not make much difference on a ship like the Enterprise, or a major hospital, but it’ll work wonders for the rural outpost clinics – they’re lucky to have any power at all, let alone reliable generators.”

 

“Aye, I told ye Mr. Spock, the stuff has a lot o’ promise.  Miss Johanna’s got some good thoughts there,” Scotty said, thinking for a moment before turning to Johanna again.  “What’re the outposts usin’ for power now?  If I remember right, the operatin’ suites are usually powered by the same material as life support…..maybe combinin’ aspects of the two…..”

 

“Yes!” Johanna grinned as she began to follow Scotty’s train of thought.  “If we took….” She trailed off as McCoy’s hand shifted in hers.  “You wakin’ up, Daddy?” she turned to McCoy.

 

McCoy’s eyes fluttered open.  “I think so,” he croaked, clearing his throat before addressing Scotty.  “Scotty, are you tryin’ to make an engineer of my daughter?”  He grumbled teasingly.

 

“The lass is already well on her way,” Scotty grinned.  “Are ye sure you didn’t start her with physics as a wee one?  She’s got quite a grasp for only havin’ a class or two.”

 

“Scotty, _you’ve_ tried to explain warp core mechanics to me…..do I seem like the type that could teach his little girl physics?” McCoy raised an eyebrow.

 

“But ye _understood_ it, Doctor,” Scotty reminded him.

 

“Yeah, only after a dozen conversations and havin’ you compare it with medical physics to get it straight in my head,” McCoy retorted.

 

“’Twasn’t _that_ difficult to teach ye Doctor,” Scotty smiled.  “Ye don’t give yerself enough credit.  Besides, ye still know a lot more about starship engineerin’ than I do about surgery,” he pointed out.

 

“I should hope so, Mr. Scott,” Spock said drily.

 

 “Why thank you, Mr. Spock,” McCoy acknowledged the underhanded compliment.

 

“To what are you referring Doctor?” Spock asked innocently, dark eyes meeting McCoy’s face.  Behind the slight mischievous spark, the true thoughts were left unspoken – _‘It is good to see you doing well, my friend.’_

 

“Apologies, Mr. Spock.  For a moment there, I thought you were actually _complimenting_ my medical skills.  My mistake,” McCoy replied, that same hint of mischievousness brightening tired blue, while underneath, he really meant, _‘Thanks for comin’ for me….and remindin’ me that not all mind melds are alike.’_

 

“Understandable, Doctor.  I have become quite accustomed to the frequency of human error,” Spock said, the barest hint of amusement lightening his expression, while his eyes replied, _‘I would not hesitate to do so again should you request my assistance.’_

 

“Yes, I’m sure you have,” McCoy drawled, a roll of his eyes silently bringing their relationship right back to its natural balance.

 

Johanna frowned.  “You in pain again Daddy?” she asked as he closed his eyes with a barely concealed grimace.

 

“It’s not bad, Jo,” McCoy answered.  “But do you mind lettin’ Chris know I’m ready to get up?”

 

Johanna was unsure for a moment before brightening with realization.  “Post-cath void?” she clarified.

 

“Yeah,” McCoy shifted uncomfortably.

 

“Okay, be right back,” Johanna said, jumping up to get Christine from the desk.

 

“Are ye sure you’re all right, Doctor?” Scotty asked, concerned at the tightness around McCoy’s eyes.

 

“I’ll be all right, Scotty,” McCoy assured the engineer.

 

“Your use of the future tense would suggest that you are not ‘all right’ at the present moment, Doctor,” Spock spoke up, watching McCoy closely.

 

McCoy rolled his eyes with a groan.  “How…..perceptive,” he sighed.  “It’s just a low-grade headache, Spock – nothin’ to get all riled-up ovah.”

 

Spock noted the thickening of McCoy’s drawl with the barest of nods.  “Of course, Doctor.  If you will excuse me,” he stood and left the room.

 

“I don’t think Mr. Spock’s buyin’ it, Doctor,” Scotty gave McCoy a pointed look.

 

“I swear, for all his Vulcan heritage…..and they say _I_ hover,” McCoy grumbled.

 

 The doors swished open.  Christine and Johanna walked in, followed slowly by Spock.  Christine walked up to the bedside, took one look at McCoy and demanded, “Who do you think you’re fooling?”

 

“Chris….” McCoy groaned.

 

“Len, when a _Vulcan_ notes the same pain cues your nursing student daughter does, you really don’t have an argument,” Christine lectured.

 

McCoy sighed heavily, but didn’t attempt to counter her observation, an action that spoke louder than any non-verbal pain cue could.

 

Christine softened, sinking onto the edge of the bed.  “I’m going to be honest, Len – I think you’re in more pain than you’re letting on and that getting upright will push you over the edge.  I’m not about to try and ambulate a vomiting patient in severe pain…especially one that’s been bedridden for a week.  I’ll help you sit up, and if you do okay, we’ll think about standing, but if the pain shoots up or you get nauseous again, your ass isn’t going anywhere.  I know you hate it, but you’ll have to deal with the urinal – it’s better than falling on your face.  Okay?”

 

McCoy nodded carefully.

 

Christine didn’t miss that reluctance.  Narrowing her eyes as he closed his eyes, she got up to gather a few things.  “Would one of you gentlemen mind staying and giving me a hand?” she asked Scotty and Spock.

 

“I will stay,” Spock offered.

 

“I should get back ta Engineering,” Scotty admitted, squeezing McCoy’s arm.  “Good luck, Doctor,” he smiled.

 

“Thanks, Scotty,” McCoy said quietly.

 

Christine brought several hypos and a urinal to the bedside.  Lowering the bed until it was completely flat, she motioned to Spock and Johanna.  “All right, we’re going to give him a boost.  Mr. Spock, if you could stand on that side, I’ll take this one and Jo, you can make sure the blankets come with us, okay?”

 

Johanna nodded.

 

“All right Leonard, ready?” Christine asked, watching Spock mirror her hold on McCoy’s arm.

 

McCoy responded with another of those carefully controlled nods.

 

Christine glanced back at the hypos on the tray behind her, before looking back to Spock.  “All right Mr. Spock, on three.  1….2….3.”  Arms linked under McCoy’s armpits, they pulled him up in bed.

 

McCoy went gray.

 

“Mr. Spock, get him upright!  Jo, get the head of the bed up!” Christine ordered, thrusting the basin in McCoy’s lap while spinning around, grabbing the antiemetic hypo and administering it swiftly.

 

Spock watched wordlessly, dark eyes bright with concern as he held the shaking physician steady while Christine prepared another hypo. 

 

“Come on Daddy, deep breaths,” Johanna’s shaky voice coached as McCoy gasped shallowly, tears running down his cheeks.

 

Christine slid the next hypo home, murmuring softly to McCoy as her eyes shifted between McCoy’s face and the monitors.

 

A few moments later, McCoy collapsed against Spock and Johanna’s grasp, sighing heavily as the medications took effect.  Watching his face go from gray to pale, Christine let out a breath of her own.

 

“Why does this keep happening?” Johanna demanded, swiping furiously at her eyes.

 

“Dr. M’Benga suggested it might be a side effect of the Fabrini compound,” Christine offered.  “Considering its persistence….”

 

McCoy snorted softly at that.

 

Christine felt a small smile touch her face.  “Welcome back, Doctor,” she said.  “Care to offer an opinion?”

 

“M’Benga’s probably right – their xenopolycythemia treatment had a similar side effect profile….” McCoy grimaced.

 

“I don’t remember treating you for anything like this after that treatment,” Christine narrowed her eyes.

 

“There was never any nausea,” McCoy clarified.

 

“But there _was_ a headache,” Christine glared.

 

“Not nearly as severe,” McCoy offered.

 

“So, obviously not worth mentioning,” Christine growled.

 

“’Not nearly as severe’,” Johanna snarled.  “This comin’ from the man who rates a 12 as an 8,” she glared at McCoy.  “This is goin’ on the list, Daddy,” she warned him.  The radiation incident wasn’t the _only_ thing she was going to give him a piece of her mind on now.

 

“Care to help me out Spock?” McCoy pleaded.

 

“I do not know what to say,” Spock said simply.

 

“Well, that makes two of us,” McCoy muttered, gingerly scrubbing his hands across his face. 

 

“All right,” Christine moved on.  “So let’s say it’s a side effect.  How do we treat it?  Acetodone, napromorphone, and now laudilone are all ineffective.”

 

“Not ineffective,” Johanna mused.  “They all had _some_ effect, just not what they _usually_ would.  The laudilone seemed to work the best….Daddy was able to sleep for awhile on that one.  What’s the duration again?” she asked Christine.

 

“Two hours,” Christine replied, eyes widening as she saw where Johanna was going.  “You’re right, Jo – the laudilone kept the pain down for its duration.  It was when it wore _off_ that the pain came back, so we’re not looking at a _recurring_ pain – it’s a _constant_ one.”

 

“What did you just give me?” McCoy asked, eyes half-mast.

 

“Laudilone and acephen,” Christine answered.

 

“That combination should last for another two hours,” McCoy said, chewing his lower lip thoughtfully, “so let’s see how it works.  If it holds out, we can just make it a PRN for when the previous dose wears off.”

 

“We’ve basically been _doing_ PRNs,” Christine pointed out.  “We can’t keep waiting for the pain to return to medicate again.  If this is constant, we need ATC meds to keep it from coming up again.  We can give you a long-acting antiemetic in the meantime, while we find a pain med that works.”

 

McCoy shook his head gingerly.  “We won’t know when it comes back with a long-acting preparation,” he argued.

 

“Isn’t that the point?  To _keep_ it from coming back?” Christine asked, confused. 

 

“Chris, we don’t know how long this lasts.  If we’re going to develop this treatment in the future, we need to know how long the side effects last in order to come up with a way to combat them,” McCoy insisted.

 

Christine froze, running his words through her head.

 

Johanna beat her to it.  “Of all the stupid…..” she burst out.  “You’ve already been lab test enough, Daddy!  So I gotta sit here an’ watch you suffer so you can learn how long the side effects last?  You’re gonna refuse adequate pain management – one of the _first_ things you always educate your patients about – because you figure you need to establish a baseline for every study that’s gonna come from this case?  I swear, sometimes I wonder if there really _is_ a brain inside that head of yours,” she shouted.

 

“Jo, I didn’t mean…..I meant that to work out the bugs for other patients….” McCoy tried to intervene.

 

“I don’t _care_ about other patients!” Johanna cried.  “I mean….I do, but in this case, _right now,_ I only care about _you,_ Daddy.  I can’t sit here while you suffer for somethin’ a lab can recreate later on.”

 

“I must agree with Johanna, Doctor,” Spock said quietly.  “While I find your scientific dedication admirable, in this case, it is not _logical_.”

 

“We can compromise, Len,” Christine said softly.  “Keep track of the symptoms while still managing them well enough for you to progress.  I’ll talk to M’Benga.  A long-acting antiemetic may help you avoid the nausea and vomiting the pain brings when it becomes severe, and it’ll help get you off the patch and fluids.  If you don’t want a long-acting pain med, we can make whatever works a routine administration.  We’ll hold it until the previous dose is up, assess your pain at that time, and whether you’re at a 1 or an 8, give you the next dose to keep it from going any higher.  What do you think?”

 

McCoy considered that for a moment before nodding.  “I’m sorry, Jo,” he whispered before turning to Christine.  “You’re right, Chris.  Thank you.  Let’s try that.”

 

“Okay,” Christine smiled as Johanna hugged McCoy fiercely, accepting his apology.  “Mr. Spock, if you would excuse us,” she motioned toward the urinal.

 

“Of course,” Spock stood, bade McCoy and Johanna farewell, and left the room.

 

Johanna excused herself as well, following Spock outside.  Christine removed the fecal catheter at McCoy’s request, assisted him in relieving himself and passed the sterilite over his hands in lieu of soap and water.  “200 ccs – congratulations,” she grinned, holding up the urinal.

 

McCoy chuckled softly.  “Thanks, Chris,” he sighed.

 

“Just don’t make this a habit,” Christine waved a hand around the ICU.  “We need you on the other side of the bed.”

 

McCoy smiled tiredly, closing his eyes.

 

“I’ll go talk to M’Benga,” Christine said quietly.  “We should have something ready when you wake up again.”

 

McCoy managed a half-nod of acknowledgement before his breathing evened out.

 

***

 

“That’s a _language_?” Johanna asked in amazement as Uhura sang across the bed from her.  “It doesn’t sound like words!”

 

Uhura smiled.  “It’s the language of the healers of Narsil,” she explained.  “Each pitch is infused with healing capacity – each song, a treatment plan.  They choose notes to sing just as physicians choose medications or surgical instruments, with the intent to cure illness.”

 

“That’s incredible,” Johanna breathed. 

 

“What’s _more_ incredible was Uhura tryin’ to teach it to me,” McCoy murmured, blinking his eyes open.

 

“You learned some?” Johanna grinned.

 

“Dr. McCoy asked me to teach him the pitches for treating the outbreak we were sent to assist with,” Uhura filled in.

 

“I never _could_ do it as well as you,” McCoy smiled at Uhura.

 

“I just had more practice than you did,” Uhura said, eyes sparkling.

 

“Yeah, and a hell of a better voice,” McCoy chuckled.

 

Uhura laughed.  “Well, whatever _you_ think of it, it’s good to hear that voice again,” she said softly, squeezing McCoy’s hand warmly.

 

“Thank you,” McCoy squeezed back.  He shifted to sit up a little further in bed, grimacing at the motion.

 

“It’s been over two hours - give me a number,” Johanna jumped on it immediately.

 

McCoy turned to look at Johanna, groaning softly.  “3?” he ventured.

 

“I’m automatically adding 4 to that,” Johanna informed him matter-of-factly, silencing his protest with a firm, “until you prove to me otherwise.”

 

“Yes ma’am,” McCoy tried to smile reassuringly through gritted teeth.

 

Johanna ran outside to find M’Benga and Christine, returning with the two a moment later. 

 

“We’ve got it!” Christine beamed, waving two hypos enthusiastically.

 

M’Benga took the chair next to McCoy’s bed, putting himself in the physician’s line of sight.  “Leonard,” he said softly, laying a gentle hand on McCoy’s arm.

 

McCoy forced pain-filled eyes open, meeting M’Benga’s dark gaze expectantly.

 

“I’m recommending the 48 hour dose of nestrodon for nausea and an 8 hour dose of a laudilone/acephen/pentgabin cocktail for pain,” M’Benga said.

 

“Pentgab – of course!” McCoy grinned enthusiastically for a moment before the pain took him again.  “The neuro component,” he groaned.

 

“Exactly,” M’Benga smiled.

 

“Go on,” McCoy consented, squeezing his eyes shut again.

 

Christine administered the hypos while Johanna excitedly explained the medications to Uhura.  “The Fabrini compound worked on neural stem cells and damaged neurons – messin’ around with the nervous system like that is bound to be painful and neurological pain doesn’t really respond to other meds.  Pentgabin works on neuro pain specifically,” Johanna grinned.

 

“And acephen is an anti-inflammatory while laudilone is a narcotic,” Christine finished.  “We’re covering all the bases.”

 

“How ya doin’, Daddy?” Johanna checked in.

 

“No nausea, pain’s down to a 1,” McCoy replied through a yawn.

 

“Good,” M’Benga smiled.  “I’ll come by in a few hours to see how everything is holding up.”

 

“Thanks, Geoff,” McCoy murmured, settling into sleep.

 

“Would you like me to let the Captain and Mr. Spock know?” Uhura asked Christine warmly as she stood to return to the Bridge.

 

“That would be great, Nyota,” Christine smiled.  “They know where to find us.”

 

***

 

Six hours later, Mara walked into the ICU for her shift.  “Well, apparently, this is the place to be,” she noted as six pairs of eyes turned to greet her.

 

“Good, you’re here!” Johanna jumped up from the bed, flashing Mara a welcoming smile.

 

“You guys miss me that much?” Mara asked suspiciously, glancing at Christine, who shook her head slightly and nodded toward Johanna for the explanation.

 

“I figured you’d wanna be here,” Johanna said with a smile.  “We’re gonna see if these meds’ll let Daddy start movin’ around.”

 

Mara raised her eyebrows, looking back to Christine and M’Benga.  “You came up with something?” she asked.

 

Christine and M’Benga pulled Mara aside to fill her in on the day’s events and the new medications.  “It’s been six hours since he got the cocktail and he’s not only denying pain, but he’s moving more freely in the bed,” Christine said.  “We’re going to start slow – see if he can tolerate sitting up and dangling his legs for a bit.  Jo asked if we could wait until you got here,” she smiled knowingly.

 

Mara grinned.  “Well then, let’s do it!”

 

Kirk and Spock stepped back as Christine and Mara returned to the bedside.  “All right,” Christine said, “we’re going to go real slow, just like I explained before, okay?” she glanced at everyone.

 

Kirk and Spock nodded.

 

“Ready, Leonard?” M’Benga asked.

 

“I’d _better_ be with this audience,” McCoy laughed nervously.

 

“Okay,” Christine laughed.  “We’ve already got baseline vitals, so Mara’s going to raise the head of the bed all the way,” she said, nodding to Mara to go ahead.  The bed clicked at 90 degrees.  “How’re you feeling?” Christine asked.

 

“Fine,” McCoy reported.  “No pain, no nausea.”

 

“Good,” M’Benga smiled, jotting the information on his PADD.

 

Five minutes later, Christine and Mara positioned themselves for the next step.  “All right, Len, we’re going to help you move to the edge of the bed.  Mara will help you straight up, then I’ll come in and help you turn.  Ready?”  At McCoy’s nod, the two women smoothly pulled him up and over so he was sitting at the edge of the bed, legs dangling over the side.

 

“Mmmm,” McCoy grunted, closing his eyes briefly.

 

“What are you feeling?” M’Benga asked.

 

“Probably just orthostatic,” McCoy replied.

 

Johanna folded her arms across her chest and glared at him.  “He asked you for a symptom, not a diagnosis, Daddy,” she grumbled.  “You’re dizzy?” she clarified.

 

“Yeah, but it’s passing,” McCoy said.

 

“How’s your pain?” Christine asked.

 

“No pain, no nausea,” McCoy confirmed.  “Probably just orthostatic from lyin’ down so long,” he repeated.

 

“Really?” Mara fixed him with a disbelieving look.  “And you can tell me your BP right now?”

 

McCoy rolled his eyes with a sigh.

 

“I didn’t think so,” Mara smirked.  “Let’s see….” She said, watching Christine run the scanner over McCoy.

 

“90/50 sitting,” Christine reported, “from 116/70 lying down.”  She tossed Mara a teasing smile.  “Sorry, Mar, but he’s right.”

 

“Lucky guess,” Mara dismissed the supportive data.

 

“Want me to guess when it’s resolved too?” McCoy challenged, raising an eyebrow with a grin.

 

Johanna’s face lit up at Kirk’s sudden burst of laughter.

 

“Let us know if you start feeling any worse,” Christine reminded McCoy.

 

“Feels good to sit up,” McCoy admitted, swinging his legs carefully.

 

“Good to _see_ you up, Bones,” Kirk affirmed.

 

After ten minutes of listening to Kirk, Spock, and Johanna debate the various merits of replicated versus home-cooked cultural dishes, McCoy caught Mara’s eye with a mischievous grin.  “It’s evened out,” he said simply.

 

Mara narrowed her eyes, taking the scanner from Christine and checking McCoy’s blood pressure.  With a dramatic sigh, she flicked the scanner closed.  “Well, you wanna give me the number too?” she asked sarcastically, unable to hide the excitement in her eyes.

 

McCoy smiled widely upon realizing he was right.  “104/66,” he guessed.

 

“Anyone else?” Mara opened the floor to responses, unsurprised when she was met with muffled, exasperated laughter.  “All right,” she acquiesced.  “You actually did even better.  110/68.  Congratulations, Leonard, you’re the picture of circulatory health,” Mara clapped.

 

Johanna practically tackled McCoy, hugging him fiercely.  “Another step, Daddy,” she whispered happily as he held her tightly.

 

Kirk was beaming and Spock’s eyes shone with pleasure.  M’Benga smiled as he noted the data, and Christine and Mara were sharing relieved grins. 

 

“Gee, you’d think I just cured the common cold,” McCoy laughed at the response.

 

“Well, you can work on that while you continue to recover, Bones,” Kirk chuckled.

 

“Actually, that reminds me….Geoff, do you have a copy of that chemical analysis I can look at?” McCoy turned to M’Benga.

 

Christine burst out laughing as M’Benga shook his head.  “I have all the pertinent data right here,” M’Benga held up the PADD.  “I must admit, I’ve been looking forward to discussing it with you.”

 

“Well then, let’s have a look at it,” McCoy insisted, motioning M’Benga to the bedside. 

 

“Well, Bones, I’ll leave you to it,” Kirk grinned, stepping forward and squeezing McCoy’s shoulder happily.  “I’ll need to borrow Dr. M’Benga in the morning though – you have your work and I have mine.”  He turned to Dr. M’Benga.  “Doctor, I’ll need you in the briefing room at 0800 tomorrow,” he said.

 

Christine caught M’Benga’s eye with an encouraging nod.

 

“Mr. Spock, if you’ll see to it that Lt. Uhura and Mr. Scott join us,” Kirk continued.

 

“Of course, Captain,” Spock replied.

 

“Good.”  Kirk glanced over at McCoy, who was already immersed in the Fabrini compound analysis.  “Now, Bones, no staying up all night reading.  Behave yourself,” Kirk teased.

 

McCoy didn’t even look up as he waved Kirk away with a grin.  “Funny, Cap’n,” he muttered.  “Go on, get,” he shooed Kirk and Spock off, blue eyes sparkling.

 

Kirk was never so happy to have been dismissed.

**Notes for the Chapter:**

> Medical Notes:
> 
> \- “We’re never even going to get him on clears, let alone progress enough to d/c the patch and fluids” refers to progressing a patient’s diet after they have been NPO (nothing by mouth). Clears = clear liquids (juice, jello, broth), which is the first step in getting back to a regular diet and off IV fluids and supplemental nutrition.  
> \- The references to Kirk rock-climbing and McCoy’s feelings on the matter refer to the fifth movie, “The Final Frontier.”  
> \- Again, the requests for McCoy to “give a number” refers to the standard pain scale where 0 = no pain and 10 = severe/worst pain ever.  
> \- “Post-cath void?” refers to making sure the patient can urinate on their own after removing a urinary catheter.  
> \- “Giving a boost” refers to pulling a patient up in bed so their head is actually somewhere near the top of the bed.  
> \- PRN stands for “as needed.” (from the Latin ‘pro re nata’ meaning ‘as the situation demands’)  
> \- ATC stands for “around the clock.”  
> \- “Orthostatic” refers to “orthostatic hypotension” which is an excessive fall in blood pressure when a patient goes from lying down to sitting or standing. It’s usually a drop by more than 20 mm Hg systolic, 10 mm Hg diastolic, or both.


	15. Chapter 15

**Summary for the Chapter:**

> McCoy is critically injured and Christine Chapel does what she does best. A character study of Leonard McCoy and a look into the world of the Enterprise medical team.

 

 

“All right, ladies and gentlemen,” Kirk began, as he paced the length of the briefing room table the next morning.  “I trust you all know why you’re here.”  He paused briefly and was met with four confirmatory nods.  “Good,” he sighed, a half-smile touching his face as he resumed his pacing.  “Then let me begin by reminding all of you that this meeting is strictly off the record.  Any ideas put forth here will be greatly appreciated, and then will become _my_ ideas.”  Kirk held up a hand at the sudden flurry of protest.  “My ship, my responsibility,” he said firmly.  “I _will_ not allow anyone else to risk their career, and that’s final.”

 

“Captain….” Spock interjected.

 

“But sir, ye cannae…..” Scotty balked at the same time.

 

“Gentlemen,” Kirk stopped them, a weary, but proud smile lighting his face.  “And lady,” he acknowledged Uhura’s gasp of concern gently.  “I am…honored to work with all of you.  Your support and dedication are beyond admirable….but if you’re all being court-martialed _with_ me, then there will be nobody left to hold Bones back from doing…..something,”  Kirk was warmed by the scattered chuckles along with the simultaneous realization of just how _good_ it felt to be able to talk about McCoy in the future tense again.  “….like coming up with a hypo that can erase _several,_ ” he cringed briefly at that realization, “court-martialable offenses from the Admiralty’s memory.”  Kirk chuckled ruefully, chewing the inside of his cheek for a moment before admitting, “Which, honestly, I wouldn’t put it past him to do.”  He grew serious again, and the room sobered.  “Bones doesn’t seem to think he’s worth all this….” Kirk swallowed, emotion thick in his throat, choking off the words he desperately sought.  He found his thoughts drifting back to Spock’s battle with the pon farr…..to sickbay where he had struggled to convince Admiral Komack of the medical and personal gravity of the situation without betraying Spock’s trust.  He recalled McCoy’s words when he refused to accept Komack’s answer.

 

_“You can’t just go to Vulcan against Starfleet orders, you’ll be busted….”_ McCoy had insisted.

 

Kirk had been equally adamant.  _“But I can’t let Spock die, can I Bones?  And he will, if we go to Altair.  I owe him my life a dozen times over.  Isn’t that worth a career?  He’s my friend.”_

 

Kirk smiled, relief flooding through him as he realized he didn’t actually need words at all – he already had them, because there was nothing he had said and felt about Spock at that moment that didn’t _exactly_ apply to McCoy as well.  He met Spock’s eyes carefully as he continued, “I once told Bones that the life of a friend was worth a career, and he helped me honor those words.  I intend to prove he’s worth it…to whatever end.”

 

Spock bowed his head in tacit understanding.  Kirk smiled at both the acknowledgement and the quiet, reminding flash of ‘there’s no way I’m letting you go down for this alone’ in the Vulcan’s dark eyes.  That loyalty _still_ touched him, even in its expectedness, but he didn’t have the time to argue martyr complexes.  There were other matters at hand.

 

Kirk cleared his throat.  “All right, let’s get to it.  Now that Medical has….managed to do the impossible…. _again_ …..” Kirk met M’Benga’s eyes with a staggering gratitude, “…Bones is on the road to recovery.  So that leaves it up to us to take care of a few…. loose ends, as it were,” Kirk sighed ruefully.  “The first being the order to map out another flare sector.  Now, Mr. Spock informed me earlier that there was no need to rush to that area, as that part of space and its flares have been unchanged for…..what was it Spock?  50 years?” Kirk checked.

 

“50.3 years, Captain,” Spock corrected.

 

“50.3,” Kirk repeated with an indulgent smile.  “However, the fact remains that we were ordered to report to that sector at a time that has long since passed.  We not only need to fulfill that order, but come up with a good enough reason for putting it off so long.”

 

“Well, Captain, you have my engineerin’ report on the ship’s damage from the first set of flares, along with my recommendation to consult Gunny at Starbase 8.  That’ll account for some o’ the time, and not wantin’ to head into another bunch of flares with the ship at less than full strength is as sound a command decision as they come,” Scotty offered.

 

“True, Mr. Scott, but that does not explain our delay in traveling to the Starbase for repairs.  Even if you were to backdate your log entries, which, if I am not mistaken, you are quite prepared to do…” Spock paused, raising an eyebrow at Scotty’s sudden blush.  “Or, perhaps you have _already_ done,” he corrected himself.

 

“ _That’s_ more like it, Mr. Spock,” Scotty mumbled with pleased embarrassment.

 

“…The timing simply would not correlate either way were someone to look closely,” Spock finished.

 

“Our ‘communication difficulties’ could explain why we didn’t inform Starfleet of the need to go to Starbase 8 earlier, but since both the Enterprise and Starbase 8 have record of our transmissions _during_ that rendezvous, we have no excuse for why we didn’t contact Starfleet about needing to delay the order either while _at_ the Starbase or in the time since leaving there,” Uhura spoke up, tapping her PADD thoughtfully before meeting Kirk’s eyes.  “That also holds for why we didn’t inform Starfleet of Dr. McCoy’s condition,” she added softly.

 

Kirk sighed heavily.  “Yes, and therein lies our greatest challenge.  The idea of Starfleet Command wondering why Dr. M’Benga was signing off on all the sickbay reports never even occurred to me.  Thankfully, Uhura pointed out that the biweekly ship logs will be going out soon, and that there’s no way we’re going to be able to hide the fact that not only has Bones _not_ been acting CMO for the past week, but that he’s also been a _patient_.”

 

“Indeed,” Spock picked up where Kirk left off.  “Medical regulations are quite specific regarding the transfer of both critically injured patients _and_ the responsibilities of the chief medical officer.”

 

“Quite correct, Mr. Spock,” M’Benga sighed. 

 

“All right,” Kirk drew a deep breath.  “We can lay in a course for that flare sector and take care of that mapping within the next two days.  We just need to explain why we waited so long to get there, why we waited to go to Starbase 8 for repairs, and why we never informed Starfleet that our CMO was critically injured so that he could be transferred off the ship and Dr. M’Benga could have been given proper orders to take over.”  Kirk laughed desperately.  “And I haven’t even _gotten_ to the fact that we have to get Johanna home somehow yet,” he scrubbed his hands across his face wearily.

 

“Now, Captain, we’ve gotten ourselves outta worse scrapes than this,” Scotty assured him, the hint of teasing meant to lighten the mood blending seamlessly with the firm certainty that they had and _could_ pull _anything_ off.

 

Uhura’s responding laughter brightened the room.  Kirk felt his spirits lift as she nodded meaningfully toward M’Benga.  “Scotty’s right, sir….and I believe that Dr. M’Benga at least has an idea for getting us back to Earth for Johanna,” she smiled demurely.

 

M’Benga sighed.  Christine had obviously relayed their earlier conversation to Uhura in an effort to make sure he spoke up.  Now, on the spot, he found himself clearing his throat nervously as Kirk’s eyes lit up at the possibility.

 

“Well, Doctor, go on,” Kirk insisted with a wave of his hand.

 

M’Benga nodded.  “I suggested to Christine that we may be able to use Leonard’s own logs to make a case for shore leave.  The crew is well overdue for a rest period and he has been documenting the need for several weeks.  I believe I’d have little difficulty in convincing Starfleet to grant the request.”

 

Uhura spoke up before Kirk could voice the doubt that flashed through his eyes.  “And I’m sure they would have a good reason to grant us leave on Earth,” she prompted M’Benga gently.

 

M’Benga met Uhura’s eyes with an appreciative smile, feeling some of the nervousness at being in what was traditionally Leonard’s position in the decision-making process ease with Uhura’s soft guidance. 

 

“Would they?” Kirk echoed, looking from Uhura to M’Benga, interest creeping in past the clouded doubt.

 

“Indeed they would Captain,” M’Benga smiled, allowing some of his own excitement to take over.  “I highly doubt Starfleet Medical would turn down the opportunity for a private presentation of a revolutionary treatment for anoxic brain injury given both by the staff that first implemented it and the patient that first received it so successfully.”

 

Kirk’s eyes widened as a familiar grin brightened his face.  “Turn Bones loose on them with all that data and hope they’ll be excited enough about the implications to overlook a few….regulatory indiscretions?” his eyes shone.

 

“Captain, the Fabrini compound is more than just a breakthrough – it completely changes how we look at anoxic brain injury, one of the few areas in modern medicine where we are no better off _now_ than we were three hundred years ago.  Lives that were once considered lost could be given the hope of restoration.  I conducted a full neurological and memory series on Leonard last night around our discussion of the chemical analysis.  Apart from being unable to recall the events directly surrounding his injury, his memories appear to be completely intact.  Johanna verified the long-term memory tests and the few minor errors in his short-term memory are more than likely attributable to his current medication regimen.  I will, of course, repeat those tests once the medications are out of his system.  Leonard is already looking at possible chemical alterations to the compound’s basic structure which may decrease the severity of the side effects, but in the meanwhile, the current cocktail is showing great promise in managing the pain and nausea as we discover the length of time these symptoms persist.  Even _if_ those symptoms turned out to be a permanent matter, we have still succeeded.  Where we once only had the option of restoring some brain stem function to a brain no longer capable of higher functioning, we now have the potential to restore necrotic tissue to its previous state, to discuss _life_ , rather than death.  Managing pain and nausea to provide for a high quality of life is _nothing_ compared to what has been achieved.”  M’Benga was practically glowing. 

       

“Aye,” Scotty’s eyes were bright.  “It’d take greater fools than even Starfleet brass to follow through on charges that would’ve prevented a discovery like that.”

 

Spock’s eyebrows shot up in reflexive disapproval, but his eyes couldn’t quite hide their begrudging agreement.

 

“What?” Scotty blustered at Spock’s reaction.  “The Captain _did_ say this was off the record.”

 

“Indeed I did, Mr. Scott,” Kirk chuckled.  “And I must admit, I’ve got half a mind to _personally_ deliver that flare data as well while we’re there,” he growled.

 

“Yeah, right up their shaft,” Scotty mumbled.

 

Kirk burst out laughing.  “Scotty, I couldn’t have said it better myself.”  He paused at Uhura’s contemplative look.  “Something on your mind, Lieutenant?” he asked.

 

“Well, sir, I was just thinking about what Scotty said….about following through on charges that would have prevented finding the treatment….” Uhura mused.

 

“Go on,” Kirk encouraged.

 

“It just reminded me of when Mr. Spock needed to return to Vulcan….how, by the time Starfleet responded several days later, granting T’Pau’s request, that you and Dr. McCoy had already taken what action was necessary.  If you had both done nothing while waiting for a response….” Uhura trailed off thoughtfully.  She hadn’t been privy to the details surrounding that incident, but she had been able to surmise enough from the reactions of those closest to Spock that it had been life-threatening.

 

Kirk’s eyes widened at both Uhura’s connection to that event and her implications for the present.  She was absolutely right.  If he hadn’t acted on McCoy’s assessment, if he had accepted Starfleet’s orders and had done nothing while waiting for a response to T’Pau’s request…..Spock would have died.  Instead, he had chosen to make use of that time and act as he would have had he been given the go-ahead.  This was no different.  If he had informed Starfleet of McCoy’s condition right away, it would have taken days for the message to be received and answered.  If they had done nothing in that time, McCoy would have remained in a state that would have required Kirk to let his friend die.  By using those few days to explore further treatment options, the medical team had come across not only a way to save McCoy’s life, but a revolutionary treatment that could save countless other lives as well.  It was all a matter of how you used your time – act like you’ve already got the world’s permission, or watch life pass by while waiting for it.  Kirk smiled.  He had always been more of a ‘seek forgiveness’ rather than ‘seek permission’ kind of guy.

 

“Uhura, you’ve just earned your pay for the rest of the mission,” Kirk grinned at the smile that bloomed across Uhura’s face.  “You are absolutely right.  What’s the point in having the best medical staff in the Fleet if you have to hold them back in an emergency, waiting on someone else’s decision?  Like Scotty said, we’ve gotten out of worse.  Starfleet couldn’t resist T’Pau’s request _then_ ……we’ll just have to make sure they won’t be able to resist the Fabrini treatment _now_.”

 

“Indeed,” M’Benga agreed, before adding, “And once the treatment was underway, it would have been medically foolish to transfer Leonard to another facility.  No one else would have been prepared to work with such archaic equipment, nor would they have had the knowledge of Leonard’s notes and the potential of the compound.  I would not have permitted it,” he said firmly.

 

Kirk smiled at the physician’s dedication – Bones would be proud.  “Agreed, Doctor,” he said.  “It may be a little late, but I’m sure they’ll see it our way.”  He felt his confidence return as he recalled his earlier response to Admiral Komack’s belated permission.  That time, he had saved Starfleet from losing the best First Officer in the Fleet.  This time he was saving them from losing their best CMO.  In truth though, neither of those facts really mattered.  In the end, it was all about saving his friends.

 

Spock sat up even straighter, if it were possible, as if he knew Kirk’s inner monologue had come to an end and that there were new orders on the horizon.  “Shall I have Mr. Chekhov lay in a course for the ordered flare sector, Captain?” he offered.

 

Kirk’s smile softened.  “Please, Mr. Spock,” he confirmed.  “And have Mr. Sulu proceed when ready.  Warp six.”

 

Spock nodded as he stood to excuse himself.

 

“Just a minute, Spock,” Kirk motioned the Vulcan back to his seat.  “Scotty,” Kirk turned to his chief engineer, “can we get away with beaming Johanna down to the surface with everyone else, or will our close proximity to Starfleet Command lead to a tighter look at our transporters?”

 

“I doubt anyone’d look so closely at a starship transporter in the middle of beamin’ down shore leave parties.  There are too many comin’ and goin’ for anyone to wanna try and follow.  But, if we need to, we can always use a shuttle – anyone who knows Dr. McCoy would understand his wantin’ to travel that way and I could fudge the bioscanners to block Miss Johanna’s biosignature just in case,” Scotty replied.

 

“Excellent, Scotty; prepare for both instances.  We’ll decide when we get there,” Kirk said.

 

“Aye, Captain, and I’ll make sure she gets some extra attention before those new flares,” Scotty patted the table affectionately.

 

Kirk chuckled his thanks before turning to his communications officer.  “Uhura, when are your reports going out?”

 

“Tomorrow morning, Captain,” Uhura said.

 

“Is there any way you could attach a note…..something to……” Kirk floundered.

 

“Smooth the way, Captain?” Uhura offered, eyes shining.

 

Kirk let out a breath.  “Exactly,” he smiled.

 

“I believe I could highlight certain points that are relevant to our reasoning, sir,” Uhura’s eyes twinkled mischievously.

 

“Uhura, you are a gem,” Kirk sighed warmly.  He looked around the table, heart swelling with pride.  “Ladies and gentlemen, I can’t thank you enough.”  His vision blurred with the dedication in those supportive eyes.  He cleared his throat quickly.  “Dismissed,” he said, strong voice thick with gratitude.  He stood as the room began to clear with a scattered murmur of quiet voices.  He turned to Spock.  “Spock, you have the conn.  I’ll join you in a little while.”

 

Spock bowed his head in acknowledgment.  Clasping his hands behind his back, he left for the Bridge.

 

“Doctor,” Kirk paused as he met M’Benga’s dark gaze.  “Well done,” he smiled, clasping the man’s shoulder in the sort of familiar gesture he generally reserved for Spock and McCoy.  “Have you seen him this morning?” he asked anxiously.

 

“I stopped by on my way here,” M’Benga said.  “He was asleep at the time, but Mara reported that he had a relatively good night.  He tended to wake up when the medication wore off, but once she got a pain rating and administered the next dose, he said he was comfortable.  The antiemetic held up all night – he denied nausea at both pain ratings.”

 

Kirk let out a relieved breath.  “Good,” he sighed.  “Was Johanna awake?” he asked.

 

“Yes,” M’Benga smiled.  “I believe Mara was teaching her some….new vocabulary.”  He wasn’t sure how Leonard was going to feel about his daughter’s new command of Orion obscenities, but he hadn’t had the heart to break up the lesson.  Laughter had been a rare commodity in sickbay lately and he wasn’t about to silence such a desperately needed positive.

 

Kirk’s grin was tinged with the barest hint of nervousness.  “Well, hopefully I won’t be introduced to any of that new vocabulary when I tell her we’re heading to another flare sector.”

 

“Captain, that young lady trusted you to honor her father’s wishes about life support before she even met you face-to-face.  She is exactly where she wants to be right now.  I highly doubt a few solar flares, even _with_ the emotional context, are enough to shake that trust,” M’Benga said simply.

 

Kirk managed a small half-smile through the raw emotion flooding his chest.  “Well then, Doctor,” he swallowed, “let’s see if you’re right.”

 

M’Benga bowed his head with a soft smile and led the way to sickbay.

 

***

 

“….We should arrive at the mapping site in two days,” Kirk finished, leaning back into McCoy’s chair with a quick stretch.  M’Benga had offered him the office to discuss the plan with Johanna.  Kirk had been grateful for the privacy. 

 

“Good,” Johanna nodded.

 

“Good?” Kirk repeated, eyeing her curiously.  “You’re okay with going into a flare sector?” he asked, keeping the ‘knowing what the last one did to your father’ silent, but for his eyes.

 

“It’s not like I’m gonna be letting him near any Engineering panels,” Johanna pointed out, jerking her chin toward the ICU.

 

“True,” Kirk acknowledged slowly, keeping his eyes on her face.  “But….” He began.

 

“But _what_ Captain?”  Johanna demanded.  “Jim,” she corrected herself with a huff at Kirk’s pointed look.  “Do I _wanna_ go into one of the things that did this to my Daddy?  No.  But what’s done is done and while I’m no Vulcan, I _do_ know the odds of something like that happening at _all_ are pretty damn low, let alone happening _again_.  You put off an order to get me to my Daddy – if _you_ can get over the worry you’re obviously feeling about going into another one of those situations, least _I_ can do is do the same.  You take care of your order.  I’ll take care of _him_ ,” Johanna’s eyes shone.

 

“You’ll be stuck here a few more days,” Kirk pointed out, somehow managing to speak through the utter surprise at Johanna’s observation of a fear he hadn’t yet admitted to himself.

 

“Stuck?!” Johanna burst out.  “Captain, you just _try_ an’ move me.  I don’t care if you find a Klingon armada in the middle of those flares and we’re delayed for weeks.  I am _exactly_ where I wanna be and no amount of time is gonna change that.  I’m not goin’ _anywhere_ until _I’m_ sure he’s fully recovered.  Got it?”

 

Kirk flinched involuntarily at the fire in those blue eyes.  “Got it,” he found himself saying.

 

“Good,” Johanna smiled.  “I hope you don’t have plans for your shore leave,” she eased swiftly into a less volatile subject.

 

“If it’s granted,” Kirk reminded her.

 

“It’ll be granted,” Johanna waved away the doubt.  “Do you?  Have plans?” she repeated.

 

“I have a feeling I’m about to,” Kirk allowed himself a lazy, anticipatory smile.

 

“Excellent deduction,” Johanna grinned.  “Save your appetite, ‘cause ya’ll are gonna learn what _real_ Georgia food tastes like.”

 

“How could I refuse when Bones recommended you so highly?” Kirk laughed.

 

“Please,” Johanna snorted.  “Who do you think taught me how to cook?”

 

Kirk’s eyebrows shot up to his hairline.  “Bones cooks?” he sputtered through his surprise.  “I mean, he _does_ make an impressive Finagle’s Folly, but….actual _food_?”

 

Johanna tapped her head with a soft smile.  “I’ve got generations of old McCoy family recipes in here.  Daddy started cooking them with me as soon as I was old enough to reach the kitchen counter.”

 

Kirk smiled at the image.

 

“You can help me fatten him back up,” Johanna’s eyes clouded with the brief pain of reality before she drew in a breath and pulled herself together.  “But first, I have to get him on his feet,” she said resolutely, heading for the door.  “You gonna come visit for a minute?” she asked.

 

“Is he still asleep?”

 

“If he is, he won’t be for long,” Johanna countered.  “You’ve got your work and we’ve got ours,” she tossed his words back with a grin.

 

Kirk laughed as he followed the familiar, purposeful step toward the ICU.

**Notes for the Chapter:**

> Episode Notes:
> 
> \- All references to pon farr, Spock needing to go to Vulcan, T’Pau and Admiral Komack’s delayed permission refer to the second season episode “Amok Time.” The two pieces of dialogue borrowed verbatim from that episode are presented in full italics.  
> \- The reference to McCoy’s ability to make a great Finagle’s Folly refers to the second season episode “The Ultimate Computer” where McCoy the psychologist once again plies his Captain with alcohol :)


	16. Epilogue

**Summary for the Chapter:**

> McCoy is critically injured and Christine Chapel does what she does best. A character study of Leonard McCoy and a look into the world of the Enterprise medical team.

**Notes for the Chapter:**

> This chapter was written a full three years after the one before it; the story became tied to a very difficult period in my life, including the diagnosis of what became a chronic medical issue. For three years, I couldn’t even look at this piece. It was only after seeing Star Trek: Into Darkness in the theater that I finally felt the spark return. The movie disappointed me on pretty much every level, but it was the relegation of McCoy to a metaphor-spewing cliché on the outskirts of the story and the outright dismissal of both Christine Chapel _and_ her profession in one throwaway line, that brought me back here in a fit of emotion. I needed to complete this story, _their_ story – the one those beautifully rich characters deserve. Thank you for reading. I am thrilled to now be able to call this complete.

 

Epilogue

 

 

There were days Christine thought the Enterprise was cursed, doomed to find the most dangerous and horrific situations the universe had to offer; ones where, even when they _did_ manage to find some way out, some hope in the hopelessness thanks to a stubborn, brilliant crew, the losses were just too great.

 

She had been to far too many funerals.

 

And then there were days like today, sitting on an old Georgia porch straight from a pre-warp society novel, sipping sweet tea with Mara as the smell of peach pie filled the air, the crew’s laughter as warm as the sun on her skin. Days where she thought that maybe, just _maybe_ , guardian angels still existed for wayward starships exploring the vastness of space.

 

The flare survey had gone without incident and McCoy continued to improve as the Enterprise subsequently made its way back to Earth for a combination of medically-approved shore leave and on Starfleet Command’s weary ‘you better have a damn good explanation for your blatant disregard of regulations _once again’_ orders. Scotty transported Johanna safely back to Earth with no one the wiser, then joined the rest of the Enterprise’s senior officers in explaining to Starfleet Command why they should still be permitted to wear the insignia.

 

Kirk continuously brought the conversation back to himself, taking responsibility for every decision that had been made along the way, whether it was directly his or not. He was forceful, passionate, yet respectful – a man who knew how to play the political game while firmly balancing both his professional oath and personal creed. A man who proved why his crew held him in such high regard, as one to be followed; the epitome of what a Starfleet Captain should be. His closing statement was a study in his friendships – it was McCoy’s passionate humanity and Spock’s well-reasoned logic, mixed with Kirk’s own deep-seated principles: “I have always understood the Enterprise’s mission to be one, not only of exploration, but one of representation – to represent Starfleet and all it stands for. To the worlds we’ve encountered, my crew _is_ Starfleet. How, then, can loyalty to them be considered _dis_ loyalty to Starfleet as a whole?”

 

The panel had agreed to withhold judgment until after sickbay’s presentation to Starfleet Medical, to get a better picture of the situation.

 

It was a wise decision.

 

Because Christine knew she wasn’t bragging when she said that they. Were. _Brilliant_.

 

From the moment of injury, to processing the Fabrini compound, to the continuing recovery process, the medical, nursing, and lab staff gave every clinical detail and implication with passionate excitement tempered with controlled personal emotion. M’Benga’s confidence grew in the presence of McCoy’s natural enthusiasm and he began speaking up more on his own as the presentation went on. Christine, Mara, and Elise practically finished each other’s sentences discussing the nursing care and implementation of fleet-wide staff education on the procedure. And McCoy…..McCoy _shone_. He was a living, breathing example of the importance of what they had done, the incredible impossibilities medicine could achieve in the hands of passionately curious, well-trained people who respected life and death, challenged the status quo, and advocated for the quality of the lives of those they took an oath to treat.

 

The clinical team didn’t miss a beat, not even when McCoy suddenly blanched mid-toe bounce and explanation, face tightening with pain. Displaying their seemingly effortless adaptability, M’Benga picked up the thread of discussion as McCoy sank into his chair, while Christine took out a prepared hypo of the pain control cocktail and administered it. Three minutes later, McCoy stood back up with a half-apologetic smile and rejoined the conversation with his easy, Southern drawl, as if nothing unusual had happened.

 

“And theah you can see both the long-term side effects _and_ their manageability,” he said, smoothly turning the episode into a teaching moment with the open excitement of a man who had not just been gray with pain a few moments before.

 

“So you receive nestrodon q48 hours and the laudilone/acephen/pentgabin cocktail q8?” one of the medical officers asked.

 

“Some days I only need the pain cocktail q12,” McCoy said, “but generally, yes, I keep that schedule.”

 

“Hell of an improvement from brain death,” the head of Starfleet Medical noted.

 

“Yes, _ma’am_ ,” McCoy smiled brightly. “We are working, however, on the possibility of a weekly or biweekly dosing regimen……”

 

When the presentation finally ended, it was to a standing ovation followed by another hour-long question and answer session.

 

“My only regret,” Mara sighed to Christine and Elise as they walked out of the conference room at the panel’s end, “is that when we publish this thing, no one will know that KCR stands for something so much better than the main Fabrini chemical compounds.”

 

“I’m just amazed that we managed to present a revolutionary neurological treatment to Starfleet’s highest medical authority _without_ you jumping up and revealing that it actually stands for ‘kickass cerebral regenin!’” Elise shook her head with a grin.

 

“I’m quite proud of that restraint,” Mara said. “Everyone knows I’m not allowed to name things.”

 

Elise raised an eyebrow.

 

“ _Outside_ of sickbay and nurse’s report,” Mara amended.

 

“I still can’t believe Leonard and M’Benga actually made that name _work_ ,” Elise chuckled.

 

“ _I_ can,” Christine said. “There’s more than one reason none of us have chosen to transfer when it’s come up.” She looked at the two physicians walking a few feet in front of them, their heads close in discussion.

 

“Damn straight,” Mara agreed.

 

And so, whether it was the existence of guardian angels or the sheer power of their status as the fleet’s miracle ship, the Enterprise once again pulled through with its brilliance and devotion leading the way. Discipline was given in the form of official letters of reprimand in personnel files, but no one lost rank or was discharged. Even Johanna kept her place in the nursing program despite lengthy clinical absences without prior approval. Citing family medical emergency and the need to be in constant comm contact – hiding her presence on the Enterprise as thoroughly as the crew did on their end – she was permitted to withdraw from the current semester without penalty and repeat the coursework the following semester.

 

With presentations completed and judgments passed, shore leave was finally, blessedly, underway.

 

And for about twenty crewmembers, it all began with an old-fashioned Georgia celebration.

 

“I swear, Daddy,” Johanna’s voice came through the open kitchen window, “sometimes I think when the good Lord was handin’ out self-preservation, you got in the wrong line.”

 

Christine chuckled softly as she came back to the present, turning toward the window to better catch the vestiges of the radiation leak discussion that had started back in sickbay.

 

“That could indeed offer a logical explanation for some of the Doctor’s…..choices,” Spock chose the last word carefully.

 

“Funny, Spock, I seem to recall treating you after several of your own ‘choices,’” McCoy raised a pointed eyebrow at the first officer, drawling that last word knowingly. “Should I start going down _your_ list?”

 

Kirk stifled a snort.

 

McCoy whipped around at the sound, waving a serving spoon at the grinning Captain. “Or _yours_?” he threatened.

 

Johanna’s eyes flickered over each of them, reading the history-laden silences.

 

Christine watched the scene with a smile. Kirk and Spock hadn’t left the kitchen since arriving at the house, under the pretense of watching and helping Johanna and a still somewhat weakened McCoy cook. Of course, it was perfectly obvious to anyone with eyes that the real motivation was not wanting McCoy out of their sight. Christine couldn’t blame them – every time she looked at McCoy it was like looking at a miracle.

 

Back in the kitchen, Kirk cleared his throat with a sheepish, pacifying smile and wisely changed the subject. “Is that cornbread ready to go on the table?” he asked.

 

Johanna and McCoy shared a sly smile before Johanna nodded, gesturing Kirk to the cornbread and asking Spock to hand her a bowl; the Vulcan stepping up to the counter a little too eagerly to be anything other than glad for the shift in focus.

 

Christine brought her attention back to the surrounding porch and backyard. Scotty and Uhura were humming and laying the table. Chekov and Sulu, having already chosen seats for the meal, sat in deep discussion about a local weapons museum. Tenzin and Settler were taking advantage of an old, towering tree’s shade, engrossed in a portable vid screen, and the medical staff were all congregated in the same porch corner where Christine and Mara sat. The nurses and orderlies were swapping old stories and jokes; M’Benga sitting slightly off to one side with his eyes closed, face tilted to the breeze, but smiling lightly at the camaraderie around his meditation.

 

With the rattle of an old screen door, McCoy stepped out onto the porch carrying an ancient looking ceramic bowl, flanked on either side by Kirk and Spock, who each held similarly laden cookware. The physician snorted back a laugh as Kirk leaned in and said something, Spock’s raised eyebrow over dancing eyes indicating his shared amusement. Johanna was two steps behind them, directing approaching crewmembers as to what else needed to be done, face bright with her father’s wide smile and joyful, shining blue eyes.

 

“Well c’mon, y’all. Let’s eat!” Johanna rallied everyone together.

 

Christine and Mara got up and went into the kitchen, grabbed the last two pitchers of lemonade left on the counter, and walked out to the long, rapidly filling table. Johanna had taken the chair to McCoy’s left, Kirk and Spock solid pillars on the physician’s right. With a father’s soft smile, McCoy leaned over to kiss Johanna’s forehead as Kirk finished pouring his and Spock’s drinks in preparation for the toast.

 

At Johanna’s excited ‘get your asses over here’ gesture, Christine and Mara set the pitchers on the table and took the open seats on Johanna’s left.

 

With everyone seated, the crew looked to its Captain, the air crackling with emotion.

 

Kirk stood up and brought his glass to chest level, the crew following suit. His gaze moved around the table, locking eyes with each of them before ending, and lingering, on McCoy.

 

“To the Enterprise,” he said, raising his glass higher.

 

_To all of you who make this ship what it is: a ship of miracles, of friendship. Of family._

 

“The Enterprise,” the table echoed within a chorus of glass meeting glass.

 

“Well go on, now - dig in!” Johanna gestured with a grin.

 

Christine listened to the light, easy conversations as food was passed around the table. Johanna blushed happily as the praise came rolling in, her gratitude swiftly followed by condolences to everyone for having to eventually go back to “that awful replicated crap.” Spock’s approval of grits tasting similar to a traditional Vulcan dish was punctuated by the familiar hiss of a hypo as McCoy gave himself his scheduled pain meds while simultaneously rolling his eyes and muttering something about visual similarities to sand and how all the butter in creation couldn’t ever make Vulcan’s deserts more palatable.

 

Kirk and Johanna burst into coughing laughter around aborted sips of lemonade, McCoy’s eyes sparkling over a wide smile that was reflected in Spock’s relaxed face and bright eyes.

 

Mara followed Christine’s line of sight and subtly tipped her glass in a private toast. “L’Chaim,” she smiled softly.

 

 Christine mirrored the action. “To life,” she agreed.

 

Lifting the glass to her lips, she took a long sip of sweet tea to the joyful sounds of celebration. They had a lot to celebrate, after all: teamwork, friendship, brilliance, devotion, loyalty. And, of course, the sum of all those admirable qualities: the warm, continued presence of Leonard McCoy - the living, breathing heart of the ship.

 

Yes, there were days Christine Chapel loved being a nurse.

 

And today?

 

Today was sure as hell one of them.


End file.
